Provider Demographics
NPI:1275935116
Name:CLANCY, WHITNEY SHEA
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:SHEA
Last Name:CLANCY
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 1:5000 ELDORADO PKWY
Mailing Address - Street 2:SUITE 430
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-8695
Mailing Address - Country:US
Mailing Address - Phone:214-436-4606
Mailing Address - Fax:214-436-4794
Practice Address - Street 1:5000 ELDORADO PKWY
Practice Address - Street 2:SUITE 430
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-8695
Practice Address - Country:US
Practice Address - Phone:214-436-4606
Practice Address - Fax:214-436-4794
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1245715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist