Provider Demographics
NPI:1356719934
Name:MCCLAIN, VALERIE KAYE (PTA)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:KAYE
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:KAYE
Other - Last Name:HUCKABY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11633 EMORY TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-8805
Mailing Address - Country:US
Mailing Address - Phone:817-781-3437
Mailing Address - Fax:
Practice Address - Street 1:3851 SW GREEN OAKS BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4130
Practice Address - Country:US
Practice Address - Phone:817-557-2030
Practice Address - Fax:817-557-3895
Is Sole Proprietor?:No
Enumeration Date:2015-09-13
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20221424225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant