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General NPI Number Information
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NPI Number | 1962132787
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Entity Type | Individual
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Provider Name | HAMUN SUWANNUCH OTR
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 1112 E COPELAND RD STE 300
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City | ARLINGTON
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State | TX
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Zip | 76011-4910
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Country | US
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Telephone | 817-505-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 7865 FIREFALL WAY APT 3510
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City | DALLAS
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State | TX
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Zip | 75230-7359
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Country | US
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Telephone | 469-939-2934
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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 | 122732
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License Number State | TX
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