Provider Demographics
NPI:1710391354
Name:O'BRYAN, KATHRYN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:O'BRYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 PINEMONT DR
Mailing Address - Street 2:200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-3132
Mailing Address - Country:US
Mailing Address - Phone:832-209-7830
Mailing Address - Fax:
Practice Address - Street 1:6701 PINEMONT DR
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-3132
Practice Address - Country:US
Practice Address - Phone:832-209-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211249224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant