Provider Demographics
NPI:1588892129
Name:MORELAN, MARY CAROL (PT, ATP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CAROL
Last Name:MORELAN
Suffix:
Gender:F
Credentials:PT, ATP
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:CAROL
Other - Last Name:ESTRADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2202 RACQUET CLUB CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-3717
Mailing Address - Country:US
Mailing Address - Phone:817-472-6201
Mailing Address - Fax:817-987-0810
Practice Address - Street 1:2202 RACQUET CLUB CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-3717
Practice Address - Country:US
Practice Address - Phone:817-472-6201
Practice Address - Fax:817-987-0810
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1090603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist