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1701 S Washington St, Suite C, Kaufman, TX 75142-3439 | |
(469) 595-3737 | |
(972) 932-5970 |
Full Name | |
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Type | Facility |
Speciality | Occupational Therapist |
Location | 1701 S Washington St, Kaufman, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063594927 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 1136588 (Texas) | Secondary |
225X00000X | Occupational Therapist | 108831 (Texas) | Primary |
Provider Name | Misty M Fairchild |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1427112218 PECOS PAC ID: 8325192743 Enrollment ID: I20090820000105 |
Provider Name | Renee C Maxwell |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1467995027 PECOS PAC ID: 3476836081 Enrollment ID: I20170206001179 |
Mailing Address | Practice Location Address |
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1701 S Washington St, Suite C, Kaufman, TX 75142-3439 Ph: (469) 595-3737 | 1701 S Washington St, Suite C, Kaufman, TX 75142-3439 Ph: (469) 595-3737 |