Provider Demographics
NPI:1114307667
Name:WURDEMAN, MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:WURDEMAN
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 1:13302 NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-5329
Mailing Address - Country:US
Mailing Address - Phone:832-257-8106
Mailing Address - Fax:
Practice Address - Street 1:903 LONGMIRE RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1817
Practice Address - Country:US
Practice Address - Phone:877-929-8875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-30
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist