Provider Demographics
NPI:1942496716
Name:MCGARY, HEATHER (PT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:MCGARY
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 1:2851 MATLOCK RD
Mailing Address - Street 2:#442
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5037
Mailing Address - Country:US
Mailing Address - Phone:817-473-6246
Mailing Address - Fax:817-473-2014
Practice Address - Street 1:2851 MATLOCK RD
Practice Address - Street 2:#442
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5037
Practice Address - Country:US
Practice Address - Phone:817-473-6246
Practice Address - Fax:817-473-2014
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7953225100000X
TX1144905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446631 GROUPMedicare PIN