Jessica Anna Chavez, COTA

Individual provider Active NPI Occupational Therapy Assistant · Mission, TX

NPI 1124508528 · NPPES record last updated Aug 16, 2018

Key facts

NPI
1124508528
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
210233 (TX)
Practice address
1200 S Bryan Rd
Mission, TX 78572-6840
Phone
(855) 687-8282
NPI assigned
Aug 16, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
210233TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 210233 TX Yes

Addresses

Primary practice location

1200 S Bryan Rd
Mission, TX 78572-6840

Mailing address

611 Viento Tropical St
Mission, TX 78572-8226

Other providers in Mission, TX

All providers in Mission, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.