Provider Demographics
NPI:1629948518
Name:CASEY, CHARIS (OTR, OTD)
Entity type:Individual
Prefix:
First Name:CHARIS
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:OTR, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 HIGHLAND HTS
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-3515
Mailing Address - Country:US
Mailing Address - Phone:210-683-3791
Mailing Address - Fax:
Practice Address - Street 1:324 RIVERWALK DR STE 312
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6936
Practice Address - Country:US
Practice Address - Phone:512-268-9130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122222225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation