Casey Brunson, OTA

Individual provider Active NPI Occupational Therapy Assistant · White Settlement, TX

NPI 1396205290 · NPPES record last updated Mar 25, 2019

Key facts

NPI
1396205290
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
212372 (TX)
Practice address
800 N Jim Wright Fwy # 2
White Settlement, TX 76108-1068
Phone
(817) 900-8441
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
212372TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 212372 TX Yes

Addresses

Primary practice location

800 N Jim Wright Fwy # 2
White Settlement, TX 76108-1068

Mailing address

800 N Jim Wright Fwy # 2
White Settlement, TX 76108-1068

Other providers in White Settlement, TX

All providers in White Settlement, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.