Provider Demographics
NPI:1093220873
Name:POPE, HONOREE MCGRAW (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HONOREE
Middle Name:MCGRAW
Last Name:POPE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HONOREE
Other - Middle Name:DAKAR
Other - Last Name:MCGRAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:105 N AUSTIN AVE APT 9203
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-4245
Mailing Address - Country:US
Mailing Address - Phone:336-782-1555
Mailing Address - Fax:
Practice Address - Street 1:4402 WILLIAMS DR STE 115
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:336-782-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-03
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013207225100000X
TX1300007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist