Individual
TED J PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
12770 COIT RD STE 870, DALLAS, TX 75251-1455
(972) 756-0500
Mailing address
12770 COIT RD STE 870, DALLAS, TX 75251-1455
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
110739
TX
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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