Provider Demographics
NPI:1780185041
Name:TERCERO, SAUL JR (OT)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:TERCERO
Suffix:JR
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 N ZARAGOZA RD STE C1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8903
Mailing Address - Country:US
Mailing Address - Phone:915-855-0601
Mailing Address - Fax:915-855-0751
Practice Address - Street 1:1512 N ZARAGOZA RD STE C1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8903
Practice Address - Country:US
Practice Address - Phone:915-855-0601
Practice Address - Fax:915-855-0751
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX397135225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics