Provider Demographics
NPI:1114221579
Name:MATTHEWS, ROSARIO TAN (OTR)
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:TAN
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 BARR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2399
Mailing Address - Country:US
Mailing Address - Phone:281-236-8178
Mailing Address - Fax:
Practice Address - Street 1:10107 BARR LAKE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2399
Practice Address - Country:US
Practice Address - Phone:281-236-8178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103453225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist