Provider Demographics
NPI:1316164692
Name:CONDON, KAREN M (PTA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:CONDON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:46 WINTER WHEAT PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4352
Mailing Address - Country:US
Mailing Address - Phone:281-292-1080
Mailing Address - Fax:
Practice Address - Street 1:17198 ST LUKES WAY
Practice Address - Street 2:SUITE 300
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8011
Practice Address - Country:US
Practice Address - Phone:936-321-0808
Practice Address - Fax:936-321-0858
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2052561225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant