Basic Information
Provider Information
NPI: 1568672244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAY
FirstName: RHONDA
MiddleName: K
NamePrefix: MS.
NameSuffix:  
Credential: PTA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12941 NORTH FWY
Address2: SUITE 401
City: HOUSTON
State: TX
PostalCode: 770601240
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber:  
Practice Location
Address1: 305 NE LOOP 820
Address2: BUSINESS TOWER 1, SUITE 200
City: HURST
State: TX
PostalCode: 760537209
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 06/14/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X2005047TXY Other Service ProvidersSpecialist 

No ID Information.


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