Provider Demographics
NPI:1326486614
Name:POPE, AMY CONNER (OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CONNER
Last Name:POPE
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 1:3223 S LOOP 289
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1337
Mailing Address - Country:US
Mailing Address - Phone:806-792-5522
Mailing Address - Fax:806-785-7582
Practice Address - Street 1:3223 S LOOP 289
Practice Address - Street 2:SUITE 101
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1337
Practice Address - Country:US
Practice Address - Phone:806-792-5522
Practice Address - Fax:806-785-7582
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103805225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist