Provider Demographics
NPI:1801529656
Name:CARIKER, GWENDOLYN KATHLEEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:KATHLEEN
Last Name:CARIKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 SPICEWOOD SPRINGS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8598
Mailing Address - Country:US
Mailing Address - Phone:512-345-4664
Mailing Address - Fax:
Practice Address - Street 1:4601 SPICEWOOD SPRINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8598
Practice Address - Country:US
Practice Address - Phone:512-345-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1280382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist