Provider Demographics
NPI:1891016382
Name:BRUMLEY, KRISTEN K
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:K
Last Name:BRUMLEY
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 1:3556 SPENCER HWY.
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-9226
Mailing Address - Country:US
Mailing Address - Phone:281-974-5095
Mailing Address - Fax:281-974-5109
Practice Address - Street 1:3556 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1110
Practice Address - Country:US
Practice Address - Phone:281-974-5095
Practice Address - Fax:281-974-5109
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1197290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist