Provider Demographics
NPI:1346745163
Name:SCHOLZ, HAILEY MARIE
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:MARIE
Last Name:SCHOLZ
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 1:19507 CEDAR COVE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1573
Mailing Address - Country:US
Mailing Address - Phone:713-865-2397
Mailing Address - Fax:
Practice Address - Street 1:29615 FM 1093 RD STE 2
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-3926
Practice Address - Country:US
Practice Address - Phone:281-533-0507
Practice Address - Fax:281-533-0521
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-25
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1294863225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty