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General NPI Number Information
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NPI Number | 1336038553
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Entity Type | Individual
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Provider Name | TAMMY HART OTR
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2055 W GRANDE BLVD
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City | TYLER
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State | TX
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Zip | 75703-0526
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Country | US
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Telephone | 903-534-0449
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 E HAWKINS PKWY APT 7310
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City | LONGVIEW
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State | TX
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Zip | 75605-8146
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Country | US
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Telephone | 903-574-7183
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 111216
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License Number State | TX
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