Provider Demographics
NPI:1790969756
Name:MCMAHAN, PATTY LOU (PT)
Entity Type:Individual
Prefix:MS
First Name:PATTY
Middle Name:LOU
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1934 HICKORY ST
Mailing Address - Street 2:HENDRICK CENTER FOR REHABILITATION
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2336
Mailing Address - Country:US
Mailing Address - Phone:325-670-6367
Mailing Address - Fax:325-670-7141
Practice Address - Street 1:1934 HICKORY ST
Practice Address - Street 2:HENDRICK CENTER FOR REHABILITATION
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2336
Practice Address - Country:US
Practice Address - Phone:325-670-6367
Practice Address - Fax:325-670-7141
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1112340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist