MEDICARE: JULIE A. CRAWFORD C.O. T. A.

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	224Z00000X	Occupational Therapy Assistant	210963	TX

General Provider Information

NPI Number	:	1275831646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE A. CRAWFORD C.O. T. A.

Provider Business Mailing Address
First Line	:	2306 LIGHT WIND DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4058
Country	:	US
Telephone Number	:	361-218-1220
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 CORONA DR STE 260B
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-4320
Country	:	US
Telephone Number	:	281-364-9695
Fax Number	:

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

Provider Enumeration Date	:	03/08/2011
Last Update Date	:	09/06/2023

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