MEDICARE: QUANITEA GREEN

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	224Z00000X	Occupational Therapy Assistant	211528	TX

General Provider Information

NPI Number	:	1730065038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUANITEA GREEN

Provider Business Mailing Address
First Line	:	1623 GARDEN DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75215-4516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12400 PRESTON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1866
Country	:	US
Telephone Number	:	972-661-3111
Fax Number	:

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

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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Directions to “ QUANITEA GREEN ” Practice Location

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