Basic Information
| Provider Information | |||||||||
| NPI: | 1740424886 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUSE | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | CARVER | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4100 N SAM HOUSTON PKWY W STE 240 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770861466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8329687155 | ||||||||
| FaxNumber: | 7133839795 | ||||||||
| Practice Location | |||||||||
| Address1: | 17937 INTERSTATE 45 S | ||||||||
| Address2: | SUITE 143 | ||||||||
| City: | SHENANDOAH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773858706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9362730015 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2009 | ||||||||
| LastUpdateDate: | 03/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1256736 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.