Provider Demographics
NPI:1891746285
Name:GOLDIE STAINES, KIMBERLY (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:GOLDIE STAINES
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13122 SKYVIEW LANDING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-8104
Mailing Address - Country:US
Mailing Address - Phone:713-702-2731
Mailing Address - Fax:713-357-7401
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 450
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-357-7400
Practice Address - Fax:713-357-7401
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109266225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand