Provider Demographics
NPI:1689742017
Name:SWEET, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SWEET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15827 ALGER DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3325
Mailing Address - Country:US
Mailing Address - Phone:713-819-2964
Mailing Address - Fax:281-438-9275
Practice Address - Street 1:15827 ALGER DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3325
Practice Address - Country:US
Practice Address - Phone:713-819-2964
Practice Address - Fax:281-438-9275
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT019054225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist