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NPI Code Detail

MEDICARE: MRS. MARTI SMITH OTR

MEDICARE:  MRS. MARTI  SMITH  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
1225XP0200XPediatric Occupational Therapist111210TX

General Provider Information

NPI Number : 1396080222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARTI SMITH OTR
Provider Business Mailing Address
First Line : 10904 ENCHANTED ROCK CV
Second Line :
City : AUSTIN
State : TX
Zip : 78726-1336
Country : US
Telephone Number : 512-249-9809
Fax Number :
Provider Business Practice Location Address
First Line : 10904 ENCHANTED ROCK CV
Second Line :
City : AUSTIN
State : TX
Zip : 78726-1336
Country : US
Telephone Number : 512-249-9809
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2012
Last Update Date : 12/04/2012

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Directions to “ MRS. MARTI SMITH OTR” Practice Location

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