Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 117273 | TX |
NPI | 1326413477 |
---|---|
Provider Name | Jay Skaria |
First Address | Dallas, TX 75204-8603 |
Second Address | Garland, TX 75042-5726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2015 |
Last Update Date | 01/12/2015 |