Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251H1200X | Hand | 100811 | TX |
Y | 225XH1200X | Occupational Therapist - Hand | 100811 | TX |
NPI | 1053363721 |
---|---|
Provider Name | Ms. Kandy K Kobar |
First Address | Grapevine, TX 76051-3930 |
Second Address | Grapevine, TX 76051-3930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 20/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P81744 | (02) |