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General NPI Number Information
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NPI Number | 1649828377
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Entity Type | Individual
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Provider Name | BETH SIMPSON OTA
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 603 E PLANTATION DR
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City | CLUTE
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State | TX
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Zip | 77531-5719
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Country | US
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Telephone | 979-265-4221
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Fax |
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Provider Business Mailing Address
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Address Line | 6103 US HIGHWAY 90A E
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City | HALLETTSVILLE
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State | TX
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Zip | 77964-5912
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 207487
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License Number State | TX
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