Provider Demographics
NPI:1548403900
Name:MALLARI, CATHERINE BAKING (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BAKING
Last Name:MALLARI
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 1:3003 SAND DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-6856
Mailing Address - Country:US
Mailing Address - Phone:318-243-9196
Mailing Address - Fax:
Practice Address - Street 1:3003 SAND DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-6856
Practice Address - Country:US
Practice Address - Phone:318-243-9196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1196199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist