Provider Demographics
NPI:1932712916
Name:LELAND, KAYLYN REA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KAYLYN
Middle Name:REA
Last Name:LELAND
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 1:19411 MCKAY DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5713
Mailing Address - Country:US
Mailing Address - Phone:281-446-2680
Mailing Address - Fax:
Practice Address - Street 1:19411 MCKAY DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5713
Practice Address - Country:US
Practice Address - Phone:218-446-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1330824225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist