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NPI Code Detail

MEDICARE: MS. SUSAN ELIZABETH CASE OTR

MEDICARE: MS. SUSAN ELIZABETH CASE OTR
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 Therapist108816TX

General Provider Information

NPI Number : 1275652950
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN ELIZABETH CASE OTR
Provider Business Mailing Address
First Line : 3131 GUADALOUPE
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-6727
Country : US
Telephone Number : 817-473-3655
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 : 03/27/2007
Last Update Date : 07/08/2007

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