Provider Demographics
NPI:1124509013
Name:KAUTEN-CREWS, ALEXIS LIZBETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LIZBETH
Last Name:KAUTEN-CREWS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:LIZBETH
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4407 N GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5311
Mailing Address - Country:US
Mailing Address - Phone:956-832-4949
Mailing Address - Fax:
Practice Address - Street 1:4407 N GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5311
Practice Address - Country:US
Practice Address - Phone:432-366-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1307736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist