Provider Demographics
NPI:1992428528
Name:ROSADO, KRISTI M (PT, DPT)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:M
Last Name:ROSADO
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 1:400 LOBO LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5218
Mailing Address - Country:US
Mailing Address - Phone:972-947-9452
Mailing Address - Fax:469-362-9836
Practice Address - Street 1:400 LOBO LN
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5218
Practice Address - Country:US
Practice Address - Phone:972-947-9452
Practice Address - Fax:469-362-9836
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist