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NPI Code Detail

MEDICARE: ANGIE TATIANA GALVIS OTR, PHD

MEDICARE: ANGIE TATIANA GALVIS OTR, PHD
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 Therapist111812TX

General Provider Information

NPI Number : 1043339500
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGIE TATIANA GALVIS OTR, PHD
Provider Business Mailing Address
First Line : 4445 EMERALD DR
Second Line :
City : CARROLLTON
State : TX
Zip : 75010-4515
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2535 LONE STAR DR
Second Line :
City : DALLAS
State : TX
Zip : 75212-6313
Country : US
Telephone Number : 214-467-9787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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