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NPI 1831996412

NPI 1831996412 : TRESSA AVESTRUZ OTR : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1831996412
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    Entity Type          |    Individual 
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    Provider Name        |    TRESSA AVESTRUZ OTR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/28/2025
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    Last Update Date     |    03/04/2025
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Provider Practice Location Address
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    Address Line         |    6207 SHERIDAN AVE 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78723-1060
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    Country              |    US
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    Telephone            |    512-454-3743
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6207 SHERIDAN AVE 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78723-1060
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    Country              |    US
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    Telephone            |    512-454-3743
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    Fax                  |    512-334-4465
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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       |    120169
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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       |    
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    License Number State |    
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