Provider Demographics
NPI:1700062544
Name:MCLEAN, WENDY S (MPT, C/NDT)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:S
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:MPT, C/NDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2353
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-0042
Mailing Address - Country:US
Mailing Address - Phone:469-400-8232
Mailing Address - Fax:469-795-6388
Practice Address - Street 1:105 S BUTLER DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2725
Practice Address - Country:US
Practice Address - Phone:469-400-8232
Practice Address - Fax:469-795-6388
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027773-1174400000X
TX12437402251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No174400000XOther Service ProvidersSpecialist