Provider Demographics
NPI:1902206030
Name:NEELON, KRISTINE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:
Last Name:NEELON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MAIN ST
Mailing Address - Street 2:UNIT 8G
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-1746
Mailing Address - Country:US
Mailing Address - Phone:832-586-5055
Mailing Address - Fax:
Practice Address - Street 1:8455 FANNIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4803
Practice Address - Country:US
Practice Address - Phone:713-795-0891
Practice Address - Fax:713-797-0049
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1248527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist