Provider Demographics
NPI:1992199715
Name:DUFF, BRIAN (OTR/L, MSOT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:DUFF
Suffix:
Gender:M
Credentials:OTR/L, MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9810 SABLE GRN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4377
Mailing Address - Country:US
Mailing Address - Phone:775-967-2856
Mailing Address - Fax:
Practice Address - Street 1:5756 N KNOLL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2238
Practice Address - Country:US
Practice Address - Phone:765-967-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114346225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist