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General NPI Number Information
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NPI Number | 1033691274
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Entity Type | Individual
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Provider Name | TIMOTHY DANIEL HATTERS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/04/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 11020 DESSAU RD
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City | AUSTIN
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State | TX
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Zip | 78754-2053
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Country | US
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Telephone | 512-873-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 E 6TH ST APT 1219
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City | AUSTIN
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State | TX
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Zip | 78702-3393
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Country | US
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Telephone | 210-355-4436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 116073
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License Number State | TX
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