MEDICARE: ALLEN JOSEPH ADLAWAN MERCEDES 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	225X00000X	Occupational Therapist	123577	TX

General Provider Information

NPI Number	:	1306539549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLEN JOSEPH ADLAWAN MERCEDES OTR/L

Provider Business Mailing Address
First Line	:	2230 BAYLEAF MANOR DR
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-5253
Country	:	US
Telephone Number	:	541-900-4850
Fax Number	:

Provider Business Practice Location Address
First Line	:	2230 BAYLEAF MANOR DR
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-5253
Country	:	US
Telephone Number	:	541-900-4850
Fax Number	:

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

Provider Enumeration Date	:	06/01/2023
Last Update Date	:	06/01/2023

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Directions to “ ALLEN JOSEPH ADLAWAN MERCEDES OTR/L” Practice Location

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