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NPI Code Detail

MEDICARE: JUAN WU

MEDICARE: JUAN WU
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 Therapist119197TX

General Provider Information

NPI Number : 1477035129
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN WU
Provider Business Mailing Address
First Line : 8732 BRUSHY CREEK TRL
Second Line :
City : FORT WORTH
State : TX
Zip : 76118-7420
Country : US
Telephone Number : 214-983-0637
Fax Number :
Provider Business Practice Location Address
First Line : 2112 FORUM PKWY
Second Line :
City : BEDFORD
State : TX
Zip : 76021-6028
Country : US
Telephone Number : 817-799-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2018
Last Update Date : 08/29/2018

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Directions to “ JUAN WU ” Practice Location

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