MEDICARE: MRS. KRISTI MICHELLE CHAPMAN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist	109052	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	109052	OTHER	TX	LICENSE #

General Provider Information

NPI Number	:	1255446472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTI MICHELLE CHAPMAN OTR/L

Provider Business Mailing Address
First Line	:	13715 MATTHIAS TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-8017
Country	:	US
Telephone Number	:	832-654-3625
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-3907
Country	:	US
Telephone Number	:	832-203-1094
Fax Number	:	832-203-1097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	11/16/2010

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