Jessica Garza, COTA

Individual provider Active NPI Occupational Therapy Assistant · Eustace, TX

NPI 1962025841 · NPPES record last updated May 26, 2020

Key facts

NPI
1962025841
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
214319 (TX)
Practice address
219 Lakeview Cir
Eustace, TX 75124-9749
Phone
(903) 286-4728
NPI assigned
May 26, 2020
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
214319TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 214319 TX Yes

Addresses

Primary practice location

219 Lakeview Cir
Eustace, TX 75124-9749

Mailing address

219 Lakeview Cir
Eustace, TX 75124-9749
Phone (903) 286-4728

Other providers in Eustace, TX

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

Sources for this page

Verify at the official NPI Registry.