Provider Demographics
NPI:1992269435
Name:WALTON, KATHRYN (OTA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WALTON
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 FM 1960 RD E STE 401
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2258
Mailing Address - Country:US
Mailing Address - Phone:281-548-2458
Mailing Address - Fax:210-340-1259
Practice Address - Street 1:7840 FM 1960 RD E STE 401
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2258
Practice Address - Country:US
Practice Address - Phone:281-548-2458
Practice Address - Fax:281-348-2456
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2133582081N0008X, 224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine