Provider Demographics
NPI:1093069957
Name:KAIEDA, HONAMI (MED, ATC, LAT)
Entity type:Individual
Prefix:
First Name:HONAMI
Middle Name:
Last Name:KAIEDA
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 FOREST HLS
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-4013
Mailing Address - Country:US
Mailing Address - Phone:812-236-5176
Mailing Address - Fax:
Practice Address - Street 1:5800 OWNBY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75275-0001
Practice Address - Country:US
Practice Address - Phone:214-768-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20682255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer