Provider Demographics
NPI:1356603336
Name:KIRBY, CORINNE KAY (PT)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:KAY
Last Name:KIRBY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19875 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6721
Mailing Address - Country:US
Mailing Address - Phone:281-343-1500
Mailing Address - Fax:281-343-0062
Practice Address - Street 1:19875 SOUTHWEST FWY
Practice Address - Street 2:SUITE 205
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6721
Practice Address - Country:US
Practice Address - Phone:281-343-1500
Practice Address - Fax:281-343-0062
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1131092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist