Provider Demographics
NPI:1285216093
Name:DOWNING, KENDALL (PT, DPT)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:
Last Name:DOWNING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13674 IRON HORSE WAY
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-3979
Mailing Address - Country:US
Mailing Address - Phone:425-281-7370
Mailing Address - Fax:
Practice Address - Street 1:3111 TPC PKWY STE 111
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2398
Practice Address - Country:US
Practice Address - Phone:210-257-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1344675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1344675OtherTEXAS LICENSE