Provider Demographics
NPI:1902374697
Name:KAMIEN, TARA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:KAMIEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:SCHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2503 APACHE ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7190
Mailing Address - Country:US
Mailing Address - Phone:715-897-1639
Mailing Address - Fax:
Practice Address - Street 1:940 CLEAR LAKE CITY BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-6606
Practice Address - Country:US
Practice Address - Phone:832-828-9132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1235102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist