Individual
CALEB BERAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 LUCAS DR, ATHENS, TX 75751-3445
(903) 675-8538
Mailing address
711 LUCAS DR, ATHENS, TX 75751-3496
(903) 675-8538
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
120104
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120104
OT BOARD TEXAS
TX
Enumeration date
09/06/2019
Last updated
09/06/2019
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