| Keith Tisdell, | |
|
189 Decker, Kyle, TX 78640-5791 | |
| (954) 328-5436 | |
| Not Available |
| Full Name | Keith Tisdell |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 189 Decker, Kyle, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477550630 | NPI | - | NPPES |
| 887054300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 10016 (Florida) | Secondary |
| 225X00000X | Occupational Therapist | 113654 (Florida) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Tisdell, 189 Decker, Kyle, TX 78640-5791 Ph: (954) 328-5436 | Keith Tisdell, 189 Decker, Kyle, TX 78640-5791 Ph: (954) 328-5436 |
Ms. Nicole Anne Brodhead, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 512-504-3035 Fax: 512-504-9287 | |
Loren Nicole Moses, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 512-504-3035 Fax: 512-504-9287 | |
Ms. Susan Jean Nickelson, OTRIL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 512-504-3035 Fax: 512-504-9287 | |
Stacy Rayann Bustos, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 132 Ashwood S, Kyle, TX 78640 Phone: 281-851-3086 | |
Logan Long, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5980 Kyle Pkwy, Kyle, TX 78640 Phone: 512-308-3015 | |
Mrs. Karen Rene Ratcliff, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 210-722-7998 Fax: 512-857-0166 |