Provider Demographics
NPI:1497862577
Name:HALLIDAY, WENDY S (MOT, OTR)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:S
Last Name:HALLIDAY
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 FALLBROOK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11301 FALLBROOK DR STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4270
Practice Address - Country:US
Practice Address - Phone:346-240-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-01-16
Deactivation Date:2012-10-31
Deactivation Code:
Reactivation Date:2019-01-02
Provider Licenses
StateLicense IDTaxonomies
TX108209225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist