| Mary Daugherty, | |
|
1321 Park Bayou Dr, Houston, TX 77077-1507 | |
| (281) 556-5280 | |
| Not Available |
| Full Name | Mary Daugherty |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1321 Park Bayou Dr, Houston, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891929097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 108427 (Texas) | Primary |
| Provider Name | Healthpro Heritage Rehab & Fitness Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1952531154 PECOS PAC ID: 6507832573 Enrollment ID: O20160330000839 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Daugherty, 7733 Forsyth Blvd, Suite 2300, Saint Louis, MO 63105-1817 Ph: () - | Mary Daugherty, 1321 Park Bayou Dr, Houston, TX 77077-1507 Ph: (281) 556-5280 |
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