Provider Demographics
NPI:1497774335
Name:DAYRIT, MARIA LUZ (PT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LUZ
Last Name:DAYRIT
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 1:4027 DOWLEN RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6850
Mailing Address - Country:US
Mailing Address - Phone:409-899-2765
Mailing Address - Fax:409-924-9468
Practice Address - Street 1:4027 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6850
Practice Address - Country:US
Practice Address - Phone:409-899-2765
Practice Address - Fax:409-924-9468
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106722225100000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153062801Medicaid
TX86648TOtherBLUE CROSS BLUE SHIELD
TX8903B2Medicare PIN