Healthcare Provider Details

I. General information

NPI: 1538454384
Provider Name (Legal Business Name): CHRYSTEAN JAMES HORSMAN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N WASHINGTON AVE
DALLAS TX
75246-1520
US

IV. Provider business mailing address

601 HINSDALE DR
ARLINGTON TX
76006-2015
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-9365
  • Fax: 214-820-9560
Mailing address:
  • Phone: 817-795-9020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number103122
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: