=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992848733
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER LEIGH GARNER OTR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 805 RUNNEBURG
-----------------------------------------------------
City | CROSBY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-328-9372
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27211 CAPERIDGE DR
-----------------------------------------------------
City | HUFFMAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77336-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-324-4909
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 105983
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------