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NPI Code Detail

MEDICARE: DEANNA K SEELEY OTA

MEDICARE: DEANNA K SEELEY OTA
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
1226000000XRecreational Therapist Assistant216759TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1123456OTHERNOTHING

General Provider Information

NPI Number : 1942870860
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA K SEELEY OTA
Provider Business Mailing Address
First Line : 5206 LA POSITA ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78233-5845
Country : US
Telephone Number : 512-417-2586
Fax Number :
Provider Business Practice Location Address
First Line : 6870 HEUERMANN RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-9605
Country : US
Telephone Number : 512-417-2586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2021
Last Update Date : 07/01/2021

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Directions to “ DEANNA K SEELEY OTA” Practice Location

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