MEDICARE: MRS. CASEY RHEA 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	110394	TX

General Provider Information

NPI Number	:	1619372992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASEY RHEA OTR

Provider Business Mailing Address
First Line	:	16175 ADDISON RD STE 102
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-3252
Country	:	US
Telephone Number	:	817-479-7019
Fax Number	:

Provider Business Practice Location Address
First Line	:	16175 ADDISON RD
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-3252
Country	:	US
Telephone Number	:	817-479-7019
Fax Number	:

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

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	06/26/2026

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