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NPI Code Detail

MEDICARE: MCKENLY ROBERTS OT

MEDICARE: MCKENLY ROBERTS OT
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 Therapist126346TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1126346OTHERTXCOMMERCIAL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548108509
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENLY ROBERTS OT
Provider Business Mailing Address
First Line : 4601 HARTFORD ST
Second Line :
City : ABILENE
State : TX
Zip : 79605-4603
Country : US
Telephone Number : 325-793-3400
Fax Number : 325-793-3587
Provider Business Practice Location Address
First Line : 4601 HARTFORD ST
Second Line :
City : ABILENE
State : TX
Zip : 79605-4603
Country : US
Telephone Number : 325-793-3400
Fax Number : 325-793-3463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ MCKENLY ROBERTS OT” Practice Location

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