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NPI Code Detail

MEDICARE: RANDY KHALAF OTR

MEDICARE:   RANDY  KHALAF  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 Therapist109355TX
2225X00000XOccupational TherapistOT2231MS

General Provider Information

NPI Number : 1326203423
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY KHALAF OTR
Provider Business Mailing Address
First Line : 4040 SAN FELIPE ST APT 120
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3941
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4040 SAN FELIPE ST APT 120
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3941
Country : US
Telephone Number : 713-877-8303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2008
Last Update Date : 07/28/2008

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