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NPI Code Detail

MEDICARE: TIMOTHY DANIEL HATTERS OTR/L

MEDICARE:   TIMOTHY DANIEL HATTERS  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist116073TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1116073OTHERTXTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

General Provider Information

NPI Number : 1033691274
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY DANIEL HATTERS OTR/L
Provider Business Mailing Address
First Line : 1630 E 6TH ST APT 1219
Second Line :
City : AUSTIN
State : TX
Zip : 78702-3393
Country : US
Telephone Number : 210-355-4436
Fax Number :
Provider Business Practice Location Address
First Line : 11020 DESSAU RD
Second Line :
City : AUSTIN
State : TX
Zip : 78754-2053
Country : US
Telephone Number : 512-873-2244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2018
Last Update Date : 09/04/2018

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Directions to “ TIMOTHY DANIEL HATTERS OTR/L” Practice Location

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