Provider Demographics
NPI:1518226976
Name:HALE, JENNIFER LEE (PT, DPT, NCS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:HALE
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23225 KINGSLAND BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2890
Mailing Address - Country:US
Mailing Address - Phone:281-395-9090
Mailing Address - Fax:281-395-9091
Practice Address - Street 1:23225 KINGSLAND BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2890
Practice Address - Country:US
Practice Address - Phone:281-395-9090
Practice Address - Fax:281-395-9091
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1175947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist