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NPI Code Detail

MEDICARE: KATRINA SANDERSON OT

MEDICARE: KATRINA SANDERSON OT
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 Therapist104604TX

General Provider Information

NPI Number : 1841773629
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA SANDERSON OT
Provider Business Mailing Address
First Line : 15637 CRUISER ST APT B
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78418-6714
Country : US
Telephone Number : 210-639-1227
Fax Number :
Provider Business Practice Location Address
First Line : 345 S WATER ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78401-2819
Country : US
Telephone Number : 210-639-1227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2018
Last Update Date : 09/08/2018

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Directions to “ KATRINA SANDERSON OT” Practice Location

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