Provider Demographics
NPI:1811952203
Name:SMATHERS, KATHRYN A (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:SMATHERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 FOSTER LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1018
Mailing Address - Country:US
Mailing Address - Phone:512-452-5700
Mailing Address - Fax:
Practice Address - Street 1:4534 W GATE BLVD
Practice Address - Street 2:TOWN AND COUNTRY PT STE 104
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1485
Practice Address - Country:US
Practice Address - Phone:512-892-7337
Practice Address - Fax:512-892-7339
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1040160225100000X
CA11306225100000X
AZ2859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist