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NPI Code Detail

MEDICARE: KRISTEN EMIG OT

MEDICARE: KRISTEN EMIG OT
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 Therapist113134TX

General Provider Information

NPI Number : 1124336714
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN EMIG OT
Provider Business Mailing Address
First Line : 3316 GREEN RIDGE ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-7252
Country : US
Telephone Number : 575-779-6282
Fax Number :
Provider Business Practice Location Address
First Line : 225 MESQUITE DR
Second Line :
City : LAGUNA VISTA
State : TX
Zip : 78578-2708
Country : US
Telephone Number : 956-943-2248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2010
Last Update Date : 09/17/2010

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Directions to “ KRISTEN EMIG OT” Practice Location

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