Provider Demographics
NPI:1639391766
Name:DURKIN, JOHN A (OTR)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:DURKIN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 S INTERSTATE 35 E
Mailing Address - Street 2:SUITE 336
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4992
Mailing Address - Country:US
Mailing Address - Phone:948-484-1100
Mailing Address - Fax:940-595-4620
Practice Address - Street 1:2436 S INTERSTATE 35 E
Practice Address - Street 2:SUITE 336
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4992
Practice Address - Country:US
Practice Address - Phone:948-484-1100
Practice Address - Fax:940-595-4620
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100453225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA335430OtherNATL BOARD CERTIFICATION