Provider Demographics
NPI:1427205178
Name:OPITZ, CHRISTINE R (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:R
Last Name:OPITZ
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 1:2400 HIGHWAY 287 N
Mailing Address - Street 2:STE 116
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4828
Mailing Address - Country:US
Mailing Address - Phone:817-689-2295
Mailing Address - Fax:817-477-3114
Practice Address - Street 1:2400 HIGHWAY 287 N
Practice Address - Street 2:STE 116
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4828
Practice Address - Country:US
Practice Address - Phone:817-689-2295
Practice Address - Fax:817-477-3114
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105295225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics