Provider Demographics
NPI:1801073259
Name:BRUNS, KRISTIE (MCD)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28010 LONGSPUR DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0341
Mailing Address - Country:US
Mailing Address - Phone:832-215-2845
Mailing Address - Fax:
Practice Address - Street 1:28010 LONGSPUR DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0341
Practice Address - Country:US
Practice Address - Phone:832-215-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19912235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist