Provider Demographics
NPI:1609977248
Name:DALLEY, SHEILA (PT, MS)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:DALLEY
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 CHARDONNAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3102
Mailing Address - Country:US
Mailing Address - Phone:832-524-8784
Mailing Address - Fax:346-570-4286
Practice Address - Street 1:1302 CHARDONNAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3102
Practice Address - Country:US
Practice Address - Phone:832-524-8784
Practice Address - Fax:346-570-4286
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1159133225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198659801Medicaid