Provider Demographics
NPI:1548222052
Name:GEORGAKAKIS, BIANCA CHRISTINE (OTR)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:CHRISTINE
Last Name:GEORGAKAKIS
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 1:5625 OVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3763
Mailing Address - Country:US
Mailing Address - Phone:214-952-0124
Mailing Address - Fax:
Practice Address - Street 1:2611 INTERNET BLVD
Practice Address - Street 2:SUITE # 107
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9085
Practice Address - Country:US
Practice Address - Phone:972-377-7289
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111596225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics