Provider Demographics
NPI:1669485389
Name:STILEN, FAITH ANNE (OTR)
Entity type:Individual
Prefix:MS
First Name:FAITH
Middle Name:ANNE
Last Name:STILEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 GREEN FALLS LANE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469
Mailing Address - Country:US
Mailing Address - Phone:281-344-1808
Mailing Address - Fax:281-344-1807
Practice Address - Street 1:1500 JACKSON ST STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3250
Practice Address - Country:US
Practice Address - Phone:281-344-1808
Practice Address - Fax:281-344-1807
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110300174400000X, 225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144001803Medicaid