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General NPI Number Information
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NPI Number | 1730721317
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Entity Type | Individual
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Provider Name | MAHLON WARE OTR
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Gender | Male
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 1707 FOUNTAINVIEW DR
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City | MANSFIELD
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State | TX
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Zip | 76063-5091
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Country | US
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Telephone | 817-752-9662
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Fax | 682-400-8251
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Provider Business Mailing Address
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Address Line | 105 SETTLERS CREEK DR
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City | DESOTO
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State | TX
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Zip | 75115-3665
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Country | US
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Telephone | 972-230-1494
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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 | 122142
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 122142
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 213733
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License Number State | TX
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