MEDICARE: KIMBERLY MCGREW OTR, CHT

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
1	225X00000X	Occupational Therapist	111009	TX

General Provider Information

NPI Number	:	1235265968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MCGREW OTR, CHT

Provider Business Mailing Address
First Line	:	11307 FM 1960 RD W
Second Line	:	STE 270
City	:	HOUSTON
State	:	TX
Zip	:	77065-4917
Country	:	US
Telephone Number	:	281-970-8002
Fax Number	:	281-970-8770

Provider Business Practice Location Address
First Line	:	11307 FM 1960 RD W
Second Line	:	STE 270
City	:	HOUSTON
State	:	TX
Zip	:	77065-4917
Country	:	US
Telephone Number	:	281-970-8002
Fax Number	:	281-970-8770

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	03/03/2016

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