Provider Demographics
NPI:1740957182
Name:TALLEY, MACI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MACI
Middle Name:
Last Name:TALLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 1601
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-0231
Mailing Address - Country:US
Mailing Address - Phone:469-854-8570
Mailing Address - Fax:
Practice Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 1601
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-0231
Practice Address - Country:US
Practice Address - Phone:469-854-8570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1350151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty