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General NPI Number Information
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NPI Number | 1144082694
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Entity Type | Individual
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Provider Name | JORDAN TAYLOR MCRAE OTR
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Gender | Female
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 4600 LOCKHILL SELMA RD STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78249-2186
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Country | US
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Telephone | 210-208-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 5843 WHITBY RD UNIT 26
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City | SAN ANTONIO
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State | TX
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Zip | 78240-4841
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Country | US
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Telephone | 214-912-9414
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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 | 124283
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License Number State | TX
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