Individual
DR. ABDIEL BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTD
Contact information
Practice address
2620 SCRIPTURE ST, DENTON, TX 76201-4315
(940) 297-6500
Mailing address
8801 QUARRY RIDGE TRL, FORT WORTH, TX 76244-5162
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
121555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121555
EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS
TX
01
—
446374
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
MA
Enumeration date
04/03/2021
Last updated
04/03/2021
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