Provider Demographics
NPI:1447733696
Name:LLAVE, ROWENA E
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:E
Last Name:LLAVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HIGHWAY 377 S STE 100
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-5140
Mailing Address - Country:US
Mailing Address - Phone:940-464-7010
Mailing Address - Fax:
Practice Address - Street 1:415 HIGHWAY 377 S STE 200
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-5140
Practice Address - Country:US
Practice Address - Phone:940-464-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103847225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist