Healthcare Provider Details

I. General information

NPI: 1881112928
Provider Name (Legal Business Name): HOPE MCCARROLL OTD, MOT, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 09/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 US HWY 380 SUITE 517
CROSSROADS TX
76227
US

IV. Provider business mailing address

8700 US HIGHWAY 380 STE 517
CROSSROADS TX
76227-2661
US

V. Phone/Fax

Practice location:
  • Phone: 866-832-1708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number114558
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: