Provider Demographics
NPI:1730440710
Name:MCANALLY, WENDY MAY (MOT)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MAY
Last Name:MCANALLY
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:MAY
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:294 W FORK DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3484
Mailing Address - Country:US
Mailing Address - Phone:832-276-2662
Mailing Address - Fax:
Practice Address - Street 1:17045 EL CAMINO REAL
Practice Address - Street 2:SUITE 106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2649
Practice Address - Country:US
Practice Address - Phone:281-480-5648
Practice Address - Fax:281-480-5691
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305132225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist