Teresa Stanaback, OTR

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

110025 Issued in TX

Practice address

9441 LBJ Freeway
Suite 602
Dallas,, TX 75243

Phone

(469) 249-1883

Fax

(887) 778-7505

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Terri Stanaback Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1164899779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10905 NE 48TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337704",
            "telephone_number": "409-392-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 LBJ FREEWAY",
            "address_2": "SUITE 602",
            "city": "DALLAS,",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "469-249-1883",
            "fax_number": "887-778-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANABACK",
        "first_name": "TERESA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "TX",
            "license": "110025",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WA",
            "license": "OT60579322",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECPTOTE",
            "identifier": "110025",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "OT 60579322",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "STANABACK",
            "credential": "OTR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher Stamper, RN
• Melodianne Stamper, RN, MSN, ACNP
• Samantha A Stamper, M.D.
• Elissa Leann Stamps, RN
• Roman Stana, MD
• Irina Stanasel
• Laura Stanczak, MSN, APRN, FNP-C
• John A. Standefer Jr., MD
• Standifer Chiropractic Clinic, P.C.
• Jeffrey Shawn Standifer, D.C.

• Physical Rehabilitation Occupational Therapist in Dallas,, TX
• Providers in Dallas,, TX by specialty
• Physical Rehabilitation Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.