Provider Demographics
NPI:1063966836
Name:CLENDENINN, KAYLA GARRETT (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:GARRETT
Last Name:CLENDENINN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:LEE
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:11450 SPACE CENTER BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3642
Mailing Address - Country:US
Mailing Address - Phone:281-998-0901
Mailing Address - Fax:281-998-0903
Practice Address - Street 1:11450 SPACE CENTER BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3642
Practice Address - Country:US
Practice Address - Phone:281-998-0901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1279542225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist