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NPI Code Detail

MEDICARE: CHARLOTTE ANN HUDSON OTR

MEDICARE: CHARLOTTE ANN HUDSON 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
1225X00000XOccupational Therapist108196TX

General Provider Information

NPI Number : 1437232923
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE ANN HUDSON OTR
Provider Business Mailing Address
First Line : 132 EAGLE CREEK RANCH BLVD
Second Line :
City : FLORESVILLE
State : TX
Zip : 78114-9236
Country : US
Telephone Number : 830-216-2593
Fax Number :
Provider Business Practice Location Address
First Line : 3651 ROGER BROOKE DRIVE
Second Line :
City : FORT SAM HOUSTON
State : TX
Zip : 78234
Country : US
Telephone Number : 210-916-2460
Fax Number : 210-916-5102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 07/08/2007

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