Provider Demographics
NPI:1407975121
Name:GIFFORD, VIRGINIA HELEN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:HELEN
Last Name:GIFFORD
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 1:911 MEDICAL CENTRE DR STE A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4758
Mailing Address - Country:US
Mailing Address - Phone:817-861-7600
Mailing Address - Fax:817-861-7601
Practice Address - Street 1:911 MEDICAL CENTRE DR STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4758
Practice Address - Country:US
Practice Address - Phone:817-861-7600
Practice Address - Fax:817-861-7601
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100573225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2992Medicare ID - Type UnspecifiedINDIVIDUAL IDENTIFIER