Provider Demographics
NPI:1992905004
Name:WISE, MARGARET F (OTR, CHT, CVE)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:F
Last Name:WISE
Suffix:
Gender:F
Credentials:OTR, CHT, CVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 CHATTANOOGA PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-6279
Mailing Address - Country:US
Mailing Address - Phone:214-352-4443
Mailing Address - Fax:214-357-2513
Practice Address - Street 1:1926 CHATTANOOGA PL
Practice Address - Street 2:SUITE A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6279
Practice Address - Country:US
Practice Address - Phone:214-352-4443
Practice Address - Fax:214-357-2513
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101262225X00000X
TXC01210225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83015TOtherBCBS