Provider Demographics
NPI:1821043506
Name:MCCARLEY, TONYA (PT)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:MCCARLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:GASTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6819 OLYMPIA DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3362
Mailing Address - Country:US
Mailing Address - Phone:713-444-5657
Mailing Address - Fax:
Practice Address - Street 1:6819 OLYMPIA DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3362
Practice Address - Country:US
Practice Address - Phone:713-444-5657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-05116-7225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2972Medicare PIN