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NPI Code Detail

MEDICARE: EMILY ANNE STAYTON OTR

MEDICARE: EMILY ANNE STAYTON 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
1225XP0200XPediatric Occupational Therapist125358TX
2225X00000XOccupational Therapist1253358TX

General Provider Information

NPI Number : 1740094291
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ANNE STAYTON OTR
Provider Business Mailing Address
First Line : PO BOX 2603
Second Line :
City : FORT WORTH
State : TX
Zip : 76113-2603
Country : US
Telephone Number : 817-569-4300
Fax Number :
Provider Business Practice Location Address
First Line : 3840 HULEN ST STE 100
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-7269
Country : US
Telephone Number : 817-569-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2025
Last Update Date : 01/27/2026

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Directions to “ EMILY ANNE STAYTON OTR” Practice Location

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