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1669198933

NPI Code Detail

MEDICARE: KYLIE MACHA OTR

MEDICARE: KYLIE MACHA 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
1	225X00000X	Occupational Therapist	122771	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669198933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE MACHA OTR

Provider Business Mailing Address
First Line	:	1905 LEARY LN
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-2899
Country	:	US
Telephone Number	:	361-573-0731
Fax Number	:	361-573-1594

Provider Business Practice Location Address
First Line	:	1905 LEARY LN
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-2899
Country	:	US
Telephone Number	:	361-573-0731
Fax Number	:	361-573-1594

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

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	10/18/2022

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Directions to “ KYLIE MACHA OTR” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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