Provider Demographics
NPI:1487816849
Name:BURR, KOLLEEN T (PT)
Entity type:Individual
Prefix:
First Name:KOLLEEN
Middle Name:T
Last Name:BURR
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 1:815 S MILAM ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4789
Mailing Address - Country:US
Mailing Address - Phone:830-205-1470
Mailing Address - Fax:210-764-0864
Practice Address - Street 1:815 S MILAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4789
Practice Address - Country:US
Practice Address - Phone:830-205-1470
Practice Address - Fax:210-764-0864
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1344003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist