Provider Demographics
NPI:1780762708
Name:KLEIHEGE, JACQUELYN LEE (PT)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:LEE
Last Name:KLEIHEGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JACQUELYN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15702 SWANDALE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-7067
Mailing Address - Country:US
Mailing Address - Phone:281-550-9397
Mailing Address - Fax:
Practice Address - Street 1:15200 SOUTHWEST FWY
Practice Address - Street 2:STE 385
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3845
Practice Address - Country:US
Practice Address - Phone:281-989-3081
Practice Address - Fax:281-494-0080
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist