Provider Demographics
NPI:1629569827
Name:MCGEE, TANYA (LMT)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2549
Mailing Address - Country:US
Mailing Address - Phone:469-315-0622
Mailing Address - Fax:
Practice Address - Street 1:604 W WHITE ST
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-3546
Practice Address - Country:US
Practice Address - Phone:469-315-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT128044225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist