MEDICARE: MRS. YANIRA MICHELLE ISLAS 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	111883	TX

General Provider Information

NPI Number	:	1770778615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YANIRA MICHELLE ISLAS OTR

Provider Business Mailing Address
First Line	:	3203 LANCELOT LN
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-3431
Country	:	US
Telephone Number	:	956-874-9184
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E DOVE AVE STE E
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-2263
Country	:	US
Telephone Number	:	956-618-1242
Fax Number	:	956-618-1360

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

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	07/15/2025

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