Provider Demographics
NPI:1902388663
Name:O'KEEFFE, CINDY L (PTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:O'KEEFFE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SKYE DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-8398
Mailing Address - Country:US
Mailing Address - Phone:830-329-3936
Mailing Address - Fax:
Practice Address - Street 1:108 E TRAILMOOR DR STE 1
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-2294
Practice Address - Country:US
Practice Address - Phone:830-990-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2014098225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant