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General NPI Number Information
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NPI Number | 1942136965
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Entity Type | Individual
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Provider Name | SAMANTHA LUISA RENDON GADE OTD, OTR
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Gender | Female
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 4811 BROADWAY ST STE B
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City | ADDISON
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State | TX
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Zip | 75001-6504
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Country | US
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Telephone | 903-752-1052
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 BLUFFTON DR
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City | PLANO
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State | TX
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Zip | 75075-7442
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Country | US
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Telephone | 903-752-1052
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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 | 126104
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License Number State | TX
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