Provider Demographics
NPI:1003339706
Name:BUTRIS, RAHAEL (OTR/L)
Entity Type:Individual
Prefix:
First Name:RAHAEL
Middle Name:
Last Name:BUTRIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 PARKWOOD BLVD APT 244
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:214-435-2480
Mailing Address - Fax:214-975-2186
Practice Address - Street 1:2949 PARKWOOD BLVD
Practice Address - Street 2:APT 244
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:214-435-2480
Practice Address - Fax:214-975-2186
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117796225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation