Provider Demographics
NPI:1851498216
Name:KLEIN, JENNIFER LEIGH (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-7012
Mailing Address - Country:US
Mailing Address - Phone:713-203-0787
Mailing Address - Fax:713-868-1319
Practice Address - Street 1:5702 FEAGAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7106
Practice Address - Country:US
Practice Address - Phone:713-203-0787
Practice Address - Fax:713-868-1319
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1051092OtherPHYSICAL THERAPY LICENSE