Provider Demographics
NPI:1881833549
Name:OGELLO, CARY MESNARD (MSPT)
Entity Type:Individual
Prefix:MS
First Name:CARY
Middle Name:MESNARD
Last Name:OGELLO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3537
Mailing Address - Country:US
Mailing Address - Phone:972-708-8600
Mailing Address - Fax:972-708-8691
Practice Address - Street 1:3020 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3537
Practice Address - Country:US
Practice Address - Phone:972-708-8600
Practice Address - Fax:972-708-8691
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist