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General NPI Number Information
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NPI Number | 1780343335
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Entity Type | Individual
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Provider Name | JEFFREY DENNIS PELLET O.T.
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Gender | Male
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 2340 W I 20
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City | ARLINGTON
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State | TX
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Zip | 76017-7600
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Country | US
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Telephone | 682-238-3243
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Fax | 817-549-0106
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Provider Business Mailing Address
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Address Line | 5904 S COOPER ST STE 104107
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City | ARLINGTON
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State | TX
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Zip | 76017-4494
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Country | US
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Telephone | 682-238-3243
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Fax | 817-549-0106
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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 | 107871
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License Number State | TX
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