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General NPI Number Information
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NPI Number | 1053120600
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Entity Type | Individual
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Provider Name | MATTHEW OSCAR REILLY OTR, OTD
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Gender | Male
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 440 US-59 LOOP S
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City | LIVINGSTON
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State | TX
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Zip | 77351
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Country | US
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Telephone | 936-328-8148
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Fax |
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Provider Business Mailing Address
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Address Line | 9701 MEYER FOREST DR
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City | HOUSTON
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State | TX
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Zip | 77096-4314
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Country | US
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Telephone | 281-739-8126
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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 | 125265
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License Number State | TX
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