Provider Demographics
NPI:1811221864
Name:MCGEHEE, LIZ ANN (PT)
Entity Type:Individual
Prefix:
First Name:LIZ
Middle Name:ANN
Last Name:MCGEHEE
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:PO BOX 3228
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-3228
Mailing Address - Country:US
Mailing Address - Phone:432-580-3700
Mailing Address - Fax:432-580-3707
Practice Address - Street 1:801 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4045
Practice Address - Country:US
Practice Address - Phone:432-580-3700
Practice Address - Fax:432-580-3707
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L22831Medicare PIN
TX8L22223Medicare PIN