Individual
MS. KIM RENEE BACCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R
Contact information
Practice address
3634 GLENN LAKES LN, SUITE 200, MISSOURI CITY, TX 77459-4062
(281) 208-6600
(281) 261-2584
Mailing address
4910 AIRPORT AVE, BUILDING D, ROSENBERG, TX 77471-5759
(281) 239-1369
(281) 239-0828
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109307
TX
225XP0200X
Pediatric Occupational Therapist
109307
TX
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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