Provider Demographics
NPI:1831349034
Name:LYNCH, KERRY A (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:A
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 I-10 EAST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029
Mailing Address - Country:US
Mailing Address - Phone:713-973-7943
Mailing Address - Fax:713-973-7947
Practice Address - Street 1:10909 I-10 EAST FREEWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029
Practice Address - Country:US
Practice Address - Phone:713-973-7943
Practice Address - Fax:713-973-7947
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1175138225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX604740021OtherTEXAS STATE FACILITY REGISTRATION NUMBER