Dustan Houghtaling, COTA

Individual provider Active NPI Occupational Therapy Assistant · Hurst, TX

NPI 1962876466 · NPPES record last updated Nov 20, 2015

Key facts

NPI
1962876466
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
211823 (TX)
Practice address
305 NE Loop 820
Business Tower 1 Suite 200
Hurst, TX 76053
Phone
(817) 292-8787
Fax
(817) 789-6849
NPI assigned
Nov 20, 2015
Sex
Male
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
211823TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 211823 TX Yes

Addresses

Primary practice location

305 NE Loop 820
Business Tower 1 Suite 200
Hurst, TX 76053

Mailing address

18317 Tall Grass Prairie Dr
Pflugerville, TX 78660-2391
Phone (512) 993-4114

Other providers in Hurst, TX

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

Sources for this page

Verify at the official NPI Registry.