Individual
MALLORY WYBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2011 BROADWAY ST STE 130, PEARLAND, TX 77581-5945
(708) 560-6588
Mailing address
2418 GEM OAK, SAN ANTONIO, TX 78232-2647
(708) 560-6588
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1266690
TX
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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