Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 443949 | TX |
N | 225XP0200X | Occupational Therapist - Pediatrics | 443949 | TX |
NPI | 1033797410 |
---|---|
Provider Name | Hanan Jalal Khalil |
First Address | Galveston, TX 77551-5950 |
Second Address | Webster, TX 77598-4301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2021 |
Last Update Date | 29/03/2021 |