Provider Demographics
NPI:1629086723
Name:REILLY, KATHERINE LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LYNN
Last Name:REILLY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1420 WELLS BRANCH PKWY
Mailing Address - Street 2:UNIT 400
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3101
Mailing Address - Country:US
Mailing Address - Phone:512-670-3238
Mailing Address - Fax:512-670-3241
Practice Address - Street 1:1420 WELLS BRANCH PKWY
Practice Address - Street 2:UNIT 400
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3101
Practice Address - Country:US
Practice Address - Phone:512-670-3238
Practice Address - Fax:512-670-3241
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11689822251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic