MEDICARE: NIKI ROSE HOSEINPOUR OTD, 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	225XH1200X	Hand Occupational Therapist	123862	TX

General Provider Information

NPI Number	:	1871377077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKI ROSE HOSEINPOUR OTD, OTR

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	7551 ELDORADO PKWY STE 300
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5604
Country	:	US
Telephone Number	:	469-625-2676
Fax Number	:

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

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	01/08/2026

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