Provider Demographics
NPI:1346510039
Name:HSU, ANNIE HSIAO-AN (OTR)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:HSIAO-AN
Last Name:HSU
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 1:3609 CALDERA BLVD
Mailing Address - Street 2:APT 205
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-2801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 TOWER DR
Practice Address - Street 2:SUITE 7
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4239
Practice Address - Country:US
Practice Address - Phone:432-335-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114158225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist