| Jessica Breanne Pham, OTR, MOT | |
|
700 E State Highway 114, Southlake, TX 76092-5236 | |
| (817) 873-2582 | |
| Not Available |
| Full Name | Jessica Breanne Pham |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 700 E State Highway 114, Southlake, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720849151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 122746 (Texas) | Primary |
| Provider Name | Healthpro Heritage Rehab & Fitness Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1952531154 PECOS PAC ID: 6507832573 Enrollment ID: O20160330000839 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Breanne Pham, OTR, MOT 5900 Longmont Dr, Denton, TX 76208-1345 Ph: (254) 495-0939 | Jessica Breanne Pham, OTR, MOT 700 E State Highway 114, Southlake, TX 76092-5236 Ph: (817) 873-2582 |
Swadhi Pillai, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 E State Highway 114, Southlake, TX 76092 Phone: 860-978-9033 | |
Emily Procter, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 Watermere Dr, Southlake, TX 76092 Phone: 817-482-1340 | |
Mrs. Tonya Paschall Sabus, O.T.R. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 101 Watermere Drive, Southlake, TX 76248 Phone: 817-253-9339 Fax: 817-337-7622 | |
Olivia Victoria Kern, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2425 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-0222 Fax: 817-442-0223 | |
Taylor Brianna Zalesky, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2425 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-0222 Fax: 817-442-0223 | |
Maureen Saffarian, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1011 S Hollow Dr, Southlake, TX 76092 Phone: 817-905-7114 | |
Laurie K Miller, MOT,OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 855 Davis Blvd, Suite 600, Southlake, TX 76092 Phone: 817-310-5457 Fax: 817-310-3428 |