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General NPI Number Information
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NPI Number | 1982900155
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Entity Type | Individual
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Provider Name | GARY R FERGUSON OTR
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Gender | Male
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/04/2011
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Provider Practice Location Address
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Address Line | 2620 SCRIPTURE ST
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City | DENTON
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State | TX
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Zip | 76201-4315
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Country | US
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Telephone | 940-297-6533
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Fax | 940-297-6535
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Provider Business Mailing Address
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Address Line | 2620 SCRIPTURE STREET
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City | DENTON
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State | TX
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Zip | 76209-1457
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Country | US
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Telephone | 940-297-6533
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Fax | 940-297-6535
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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 | 105460
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License Number State | TX
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