Provider Demographics
NPI:1801124532
Name:DANIEL-HOLLIES, TRICIA (PT)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:DANIEL-HOLLIES
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 1:13819 COUSHATTA CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4096
Mailing Address - Country:US
Mailing Address - Phone:504-319-0611
Mailing Address - Fax:281-858-5345
Practice Address - Street 1:12570 CLAY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-5593
Practice Address - Country:US
Practice Address - Phone:713-983-0075
Practice Address - Fax:281-858-5345
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11668202251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics