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NPI Code Detail

MEDICARE: MRS. M. TERESA SMITH OTR

MEDICARE: MRS. M. TERESA SMITH OTR
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
1225XP0200XPediatric Occupational Therapist101847TX

General Provider Information

NPI Number : 1316007818
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. M. TERESA SMITH OTR
Provider Business Mailing Address
First Line : 2503 BANDELIER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77080-3811
Country : US
Telephone Number : 713-690-6734
Fax Number :
Provider Business Practice Location Address
First Line : 8021 BISSONNET ST
Second Line :
City : HOUSTON
State : TX
Zip : 77074-5200
Country : US
Telephone Number : 713-774-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/08/2007

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