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NPI Code Detail

MEDICARE: MS. HEATHER ELIZABETH O'BRIEN OTR

MEDICARE: MS. HEATHER ELIZABETH O'BRIEN 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
1225XP0200XPediatric Occupational Therapist107536TX
2225XN1300XNeurorehabilitation Occupational Therapist107536TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18T0947OTHERTXBCBS
275285003678239A007OTHERTXTRICARE

General Provider Information

NPI Number : 1922110550
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER ELIZABETH O'BRIEN OTR
Provider Business Mailing Address
First Line : 1248 AUSTIN HWY STE 210
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-4867
Country : US
Telephone Number : 210-646-8008
Fax Number : 210-646-8242
Provider Business Practice Location Address
First Line : 1248 AUSTIN HWY STE 210
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-4867
Country : US
Telephone Number : 219-646-8008
Fax Number : 210-646-8242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 10/21/2019

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