Provider Demographics
NPI:1598952640
Name:MYERS, DAVID R JR (OTR, CHT, MOT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:OTR, CHT, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4897 STATE HIGHWAY 121
Mailing Address - Street 2:STE 200
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2911
Mailing Address - Country:US
Mailing Address - Phone:469-664-0026
Mailing Address - Fax:469-664-0008
Practice Address - Street 1:4897 STATE HIGHWAY 121 STE 200
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2911
Practice Address - Country:US
Practice Address - Phone:469-664-0026
Practice Address - Fax:469-664-0008
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200172225XH1200X
TX115139225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1629506803OtherASCEND HAND THERAPY, CLINIC NPI
LA3B438CQ94OtherMEDICARE PTAN NUMBER