Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1005556 | TX |
N | 225XE0001X | Environmental Modification | 100556 | TX |
N | 225XL0004X | Low Vision | 100556 | TX |
NPI | 1841579430 |
---|---|
Provider Name | Eileen Rosendale Garza |
First Address | Magnolia, TX 77354-2914 |
Second Address | Magnolia, TX 77354-2914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2011 |
Last Update Date | 12/08/2011 |