Individual
BIJU JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
940 YORK DR, DESOTO, TX 75115-2042
(972) 572-6200
Mailing address
940 YORK DR, DESOTO, TX 75115-2042
(972) 572-6200
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
206684
TX
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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