Provider Demographics
NPI:1518510890
Name:WALKER, TOBIE MICHELLE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:TOBIE
Middle Name:MICHELLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 FM 1953
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642-2921
Mailing Address - Country:US
Mailing Address - Phone:254-652-7945
Mailing Address - Fax:
Practice Address - Street 1:251 FM 1953
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642-2921
Practice Address - Country:US
Practice Address - Phone:254-652-7945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214650224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJEA011507230OtherBCBS