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General NPI Number Information
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NPI Number | 1184315301
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Entity Type | Individual
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Provider Name | JOSUE JOEL DIMAS OT/R
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Gender | Male
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 208 STARR ST STE 2
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City | MERCEDES
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State | TX
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Zip | 78570-2736
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Country | US
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Telephone | 956-514-1551
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 E MILE 15 N
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City | WESLACO
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State | TX
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Zip | 78599-0287
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Country | US
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Telephone | 956-975-7452
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 123579
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License Number State | TX
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