Provider Demographics
NPI:1871603571
Name:KUGLER, MICAELA
Entity type:Individual
Prefix:
First Name:MICAELA
Middle Name:
Last Name:KUGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 BAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6244
Mailing Address - Country:US
Mailing Address - Phone:512-347-9385
Mailing Address - Fax:
Practice Address - Street 1:3901 S LAMAR BLVD
Practice Address - Street 2:STE 140
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8801
Practice Address - Country:US
Practice Address - Phone:512-462-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1153861OtherLICENSE#