Provider Demographics
NPI:1245778042
Name:MCCRARY, ELIZABETH (MS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MCCRARY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8006 DEER TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-3353
Mailing Address - Country:US
Mailing Address - Phone:214-546-1133
Mailing Address - Fax:
Practice Address - Street 1:10503 METRIC DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5514
Practice Address - Country:US
Practice Address - Phone:972-644-2076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11163742251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology