Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 217073 | TX |
NPI | 1609530179 |
---|---|
Provider Name | Rony Tom Andrews |
First Address | Houston, TX 77089-6086 |
Second Address | Houston, TX 77089-6086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2021 |
Last Update Date | 29/10/2021 |