Provider Demographics
NPI:1356408553
Name:SLAVIN, TAMMI (OTR,CHT)
Entity type:Individual
Prefix:MRS
First Name:TAMMI
Middle Name:
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:OTR,CHT
Other - Prefix:MRS
Other - First Name:TAMMI
Other - Middle Name:
Other - Last Name:SLAVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR,CHT
Mailing Address - Street 1:5017 SARATOGA BLVD
Mailing Address - Street 2:STE 139
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2839
Mailing Address - Country:US
Mailing Address - Phone:361-814-4800
Mailing Address - Fax:
Practice Address - Street 1:5017 SARATOGA BLVD
Practice Address - Street 2:STE 139
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2839
Practice Address - Country:US
Practice Address - Phone:361-814-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107558225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B5230Medicare ID - Type UnspecifiedMEDICARE
TXQ14153Medicare UPIN