Individual
JASON FARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4100 MOORES LN, TEXARKANA, TX 75503-5102
(903) 733-1557
Mailing address
4100 MOORES LN, TEXARKANA, TX 75503-5102
(903) 733-1557
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
111457
TX
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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