MEDICARE: DALLAS OCCUPATIONAL THERAPY SERVICES FOR KIDS, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2251P0200X	Pediatric Physical Therapist
2	235Z00000X	Speech-Language Pathologist
3	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1144488222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS OCCUPATIONAL THERAPY SERVICES FOR KIDS, PLLC

Provider Business Mailing Address
First Line	:	13720 MIDWAY RD
Second Line	:	SUITE 107
City	:	DALLAS
State	:	TX
Zip	:	75244-4313
Country	:	US
Telephone Number	:	214-646-1449
Fax Number	:	214-699-8962

Provider Business Practice Location Address
First Line	:	13720 MIDWAY RD
Second Line	:	SUITE 107
City	:	DALLAS
State	:	TX
Zip	:	75244-4313
Country	:	US
Telephone Number	:	214-646-1449
Fax Number	:	214-516-7979

Authorized Official
Title or Position	:	DIRECTOR/THERAPIST IN CHARGE
Name	:	MS. AMY SABA ORNELAS
Credential	:	OTR
Telephone Number	:	214-646-1449

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	04/28/2015

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