MEDICARE: TIMOTHY POLICARPIO 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
1	225X00000X	Occupational Therapist	120479	TX

General Provider Information

NPI Number	:	1558023242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY POLICARPIO OTR

Provider Business Mailing Address
First Line	:	1111 JUSTICE AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79416-5942
Country	:	US
Telephone Number	:	806-319-3835
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BINZ ST STE 630
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6944
Country	:	US
Telephone Number	:	832-648-3350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2021
Last Update Date	:	08/31/2023

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Directions to “ TIMOTHY POLICARPIO OTR” Practice Location

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