Provider Demographics
NPI:1538294558
Name:CAESAR, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CAESAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:LOYACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8537 SPECTRUM DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-5860
Mailing Address - Country:US
Mailing Address - Phone:570-332-2624
Mailing Address - Fax:
Practice Address - Street 1:8537 SPECTRUM DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-5860
Practice Address - Country:US
Practice Address - Phone:570-332-2624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011901-1225X00000X
PA04-261372225X00000X
TX113442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019297820003Medicaid