Provider Demographics
NPI:1619099371
Name:STROSS, KATHLEEN DEYO (PT, MS)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:DEYO
Last Name:STROSS
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 N WEBBER DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9414
Mailing Address - Country:US
Mailing Address - Phone:713-392-1303
Mailing Address - Fax:281-489-2972
Practice Address - Street 1:4207 N WEBBER DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9414
Practice Address - Country:US
Practice Address - Phone:713-392-1303
Practice Address - Fax:281-489-2972
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1060861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist