Provider Demographics
NPI:1306590179
Name:PARRISH, KIRSTEN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:
Last Name:PARRISH
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 1:6550 SHADY BROOK LN APT 812
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1212
Mailing Address - Country:US
Mailing Address - Phone:817-559-3664
Mailing Address - Fax:
Practice Address - Street 1:1313 N BELT LINE RD STE 102
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1784
Practice Address - Country:US
Practice Address - Phone:972-289-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1357801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist