Provider Demographics
NPI:1245331966
Name:PACE, MARY BETH (MSPT DC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:BETH
Last Name:PACE
Suffix:
Gender:F
Credentials:MSPT DC
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:PACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT DC
Mailing Address - Street 1:6731 STELLA LINK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4342
Mailing Address - Country:US
Mailing Address - Phone:713-662-9900
Mailing Address - Fax:713-662-9919
Practice Address - Street 1:6731 STELLA LINK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4342
Practice Address - Country:US
Practice Address - Phone:713-662-9900
Practice Address - Fax:713-662-9919
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043552225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX611881300OtherOWCP
TX181900502Medicaid
TX8T1420OtherBCBS
TX8C9496Medicare PIN