Provider Demographics
NPI:1851590095
Name:MCDONALD, KRISTINA LYN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LYN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E HOUSTON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4554
Mailing Address - Country:US
Mailing Address - Phone:281-592-2884
Mailing Address - Fax:281-592-3269
Practice Address - Street 1:300 E HOUSTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4554
Practice Address - Country:US
Practice Address - Phone:281-592-2884
Practice Address - Fax:281-592-3269
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1111151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist