Provider Demographics
NPI:1659546190
Name:DOGGETT, DEIDRE MICHELLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEIDRE
Middle Name:MICHELLE
Last Name:DOGGETT
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 1:4811 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3968
Mailing Address - Country:US
Mailing Address - Phone:281-208-9348
Mailing Address - Fax:281-208-9435
Practice Address - Street 1:4811 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3968
Practice Address - Country:US
Practice Address - Phone:281-208-9348
Practice Address - Fax:281-208-9435
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1165058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist