Provider Demographics
NPI:1922105071
Name:FINEHOUT, MARY REA (DC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:REA
Last Name:FINEHOUT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 N AZALEA ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4151
Mailing Address - Country:US
Mailing Address - Phone:361-573-3631
Mailing Address - Fax:361-573-3631
Practice Address - Street 1:2601 N AZALEA ST
Practice Address - Street 2:SUITE 14
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4151
Practice Address - Country:US
Practice Address - Phone:361-573-3631
Practice Address - Fax:361-573-3631
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2090111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
600071Medicare UPIN