Provider Demographics
NPI:1053469239
Name:STUBBS, MARY JANE (PT, MS)
Entity Type:Individual
Prefix:MS
First Name:MARY JANE
Middle Name:
Last Name:STUBBS
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11711 MEMORIAL DR
Mailing Address - Street 2:APT. 252
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7255
Mailing Address - Country:US
Mailing Address - Phone:713-974-4087
Mailing Address - Fax:713-974-4087
Practice Address - Street 1:1300 BINZ ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7016
Practice Address - Country:US
Practice Address - Phone:713-285-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10267302251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics