Provider Demographics
NPI:1730558206
Name:TO, PETE (OTR)
Entity type:Individual
Prefix:
First Name:PETE
Middle Name:
Last Name:TO
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:MR
Other - First Name:PETE
Other - Middle Name:KIN MAN
Other - Last Name:TO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:4021 NORCROSS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7237
Mailing Address - Country:US
Mailing Address - Phone:972-571-4034
Mailing Address - Fax:
Practice Address - Street 1:4021 NORCROSS DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7237
Practice Address - Country:US
Practice Address - Phone:972-571-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist