Individual
IXEL DE LA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
503 W OCEAN BLVD, LOS FRESNOS, TX 78566-3635
(956) 233-4111
Mailing address
503 W OCEAN BLVD, LOS FRESNOS, TX 78566-3635
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119886
TX
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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