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NPI 1427716448

NPI 1427716448 : STEFANIE LOPEZ MONTANO OTR : FORT SAM HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1427716448
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    Entity Type          |    Individual 
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    Provider Name        |    STEFANIE LOPEZ MONTANO OTR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/07/2021
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    Last Update Date     |    05/20/2025
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Provider Practice Location Address
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    Address Line         |    3551 ROGER BROOKE DR 
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    City                 |    FORT SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234-4504
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    Country              |    US
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    Telephone            |    808-465-0368
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3551 ROGER BROOKE DR 
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    City                 |    FORT SAM HOUSTON
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    State                |    TX
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    Zip                  |    78234-4504
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    Country              |    US
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    Telephone            |    808-465-0368
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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       |    OT-1854
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    License Number State |    HI
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Taxonomy #2
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    118995
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    License Number State |    TX
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