Provider Demographics
NPI:1801942966
Name:ISOM, KRISTA K (PT)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:K
Last Name:ISOM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3301 SUNDOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8032
Mailing Address - Country:US
Mailing Address - Phone:940-387-3700
Mailing Address - Fax:940-488-4513
Practice Address - Street 1:3301 SUNDOWN BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8032
Practice Address - Country:US
Practice Address - Phone:940-387-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1147995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K9137Medicare UPIN