MEDICARE: MS. VICTORIA HASSARD FARBER 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
1	225X00000X	Occupational Therapist	100480	TX

General Provider Information

NPI Number	:	1295055374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA HASSARD FARBER OTR

Provider Business Mailing Address
First Line	:	5133 COMSTOCK CIR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7700
Country	:	US
Telephone Number	:	817-741-5934
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 BRIDGE ST
Second Line	:	SUITE 490
City	:	FT WORTH
State	:	TX
Zip	:	76112-2384
Country	:	US
Telephone Number	:	817-446-5000
Fax Number	:

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

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	06/10/2010

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