Provider Demographics
NPI:1508081605
Name:CHOPELAS, TAMMY L (OTR)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:CHOPELAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:L
Other - Last Name:LONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 1663
Mailing Address - Street 2:
Mailing Address - City:ODEM
Mailing Address - State:TX
Mailing Address - Zip Code:78370-1663
Mailing Address - Country:US
Mailing Address - Phone:361-368-9115
Mailing Address - Fax:
Practice Address - Street 1:600 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2235
Practice Address - Country:US
Practice Address - Phone:361-881-3123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107829225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B9077Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER