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General NPI Number Information
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NPI Number | 1114020609
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Entity Type | Individual
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Provider Name | SHANNON SHOWAH OT, PTA
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 3330 MATLOCK RD STE 206
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City | ARLINGTON
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State | TX
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Zip | 76015-2917
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Country | US
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Telephone | 214-339-4533
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 COTILLION DR
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City | ARLINGTON
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State | TX
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Zip | 76017-3431
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Country | US
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Telephone | 817-729-3515
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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 |
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License Number State |
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