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General NPI Number Information
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NPI Number | 1487136776
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Entity Type | Individual
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Provider Name | MURIEL KIM JIMENEZ OTR
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Gender | Female
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Dates
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Enumeration Date | 09/03/2018
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Last Update Date | 09/04/2018
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Provider Practice Location Address
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Address Line | 6301 GASTON AVE # 162P
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City | DALLAS
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State | TX
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Zip | 75214
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Country | US
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Telephone | 214-212-3048
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 S CESAR CHAVEZ BLVD APT 1081
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City | DALLAS
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State | TX
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Zip | 75201-6074
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Country | US
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Telephone | 972-467-4464
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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 | 119378
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License Number State | TX
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