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NPI Code Detail

MEDICARE: ASHLEY LAUREN PRUETT

MEDICARE: ASHLEY LAUREN PRUETT
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 Therapist114109TX

General Provider Information

NPI Number : 1295218584
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LAUREN PRUETT
Provider Business Mailing Address
First Line : 10426 CAYUSE CV
Second Line :
City : AUSTIN
State : TX
Zip : 78748-2330
Country : US
Telephone Number : 417-737-0000
Fax Number :
Provider Business Practice Location Address
First Line : 6500 BRUSH COUNTRY RD
Second Line :
City : AUSTIN
State : TX
Zip : 78749-1403
Country : US
Telephone Number : 512-892-5774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2018
Last Update Date : 09/12/2018

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Directions to “ ASHLEY LAUREN PRUETT ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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