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NPI Code Detail

MEDICARE: JESSICA SHOWALTER OTA

MEDICARE: JESSICA SHOWALTER OTA
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
1224Z00000XOccupational Therapy Assistant213073TX

General Provider Information

NPI Number : 1811368798
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SHOWALTER OTA
Provider Business Mailing Address
First Line : 1431 GREENWAY DR STE 500
Second Line :
City : IRVING
State : TX
Zip : 75038-2444
Country : US
Telephone Number : 877-688-2520
Fax Number :
Provider Business Practice Location Address
First Line : 1431 GREENWAY DR STE 500
Second Line :
City : IRVING
State : TX
Zip : 75038-2444
Country : US
Telephone Number : 877-688-2520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2015
Last Update Date : 08/13/2025

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Directions to “ JESSICA SHOWALTER OTA” Practice Location

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