Provider Demographics
NPI:1225798135
Name:SHAMBRY, KRISTINA J (OTR, MS, OTD)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:J
Last Name:SHAMBRY
Suffix:
Gender:
Credentials:OTR, MS, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 BIRDWELL CV
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6834
Mailing Address - Country:US
Mailing Address - Phone:512-710-4798
Mailing Address - Fax:
Practice Address - Street 1:5900 BALCONES DR # 19517
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:512-710-4798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026300225X00000X
TX123308225X00000X
NJ46TR01024100225X00000X
CA24585225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty