Provider Demographics
NPI:1386941144
Name:EAVES, KRISTEN ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:EAVES
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 1:1605 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-7834
Mailing Address - Country:US
Mailing Address - Phone:806-288-7891
Mailing Address - Fax:806-288-7920
Practice Address - Street 1:1605 W 5TH ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-7834
Practice Address - Country:US
Practice Address - Phone:806-288-7891
Practice Address - Fax:806-288-7920
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12034402251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB124661Medicare PIN