Provider Demographics
NPI:1609265370
Name:HEDRICK, KAYCE DENISE (DPT)
Entity Type:Individual
Prefix:
First Name:KAYCE
Middle Name:DENISE
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAYCE
Other - Middle Name:DENISE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3121 UNIVERSITY DR E STE 100
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3499
Mailing Address - Country:US
Mailing Address - Phone:979-776-0169
Mailing Address - Fax:979-776-1372
Practice Address - Street 1:3121 UNIVERSITY DR E STE 100
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3499
Practice Address - Country:US
Practice Address - Phone:979-776-0169
Practice Address - Fax:979-776-1372
Is Sole Proprietor?:No
Enumeration Date:2015-01-17
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1255285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist