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NPI Code Detail

MEDICARE: IRENE ATITAYA RATTITHAM OTD

MEDICARE: IRENE ATITAYA RATTITHAM OTD
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 TherapistTX

General Provider Information

NPI Number : 1639033186
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE ATITAYA RATTITHAM OTD
Provider Business Mailing Address
First Line : 3903 N US HIGHWAY 75 STE 100
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2578
Country : US
Telephone Number : 903-518-8678
Fax Number :
Provider Business Practice Location Address
First Line : 3903 N US HIGHWAY 75 STE 100
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2578
Country : US
Telephone Number : 903-518-8678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ IRENE ATITAYA RATTITHAM OTD” Practice Location

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