Provider Demographics
NPI:1609115419
Name:SHOEMAKER, MARGARET BYRNE (OT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:BYRNE
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ANN
Other - Last Name:SHOEMAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:605 DONNIE AVE
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-8918
Mailing Address - Country:US
Mailing Address - Phone:254-634-8505
Mailing Address - Fax:254-221-7710
Practice Address - Street 1:1102 WINKLER AVE
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6249
Practice Address - Country:US
Practice Address - Phone:254-634-8505
Practice Address - Fax:254-221-7710
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112493225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist