Provider Demographics
NPI:1861974099
Name:PADGETT, MALINDA KAYE (OTR)
Entity type:Individual
Prefix:
First Name:MALINDA
Middle Name:KAYE
Last Name:PADGETT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MALINDA
Other - Middle Name:KAYE
Other - Last Name:PADGETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2802 HUNTERS RUN
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-6015
Mailing Address - Country:US
Mailing Address - Phone:325-642-8817
Mailing Address - Fax:
Practice Address - Street 1:400 OLD SIDNEY RD
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-2137
Practice Address - Country:US
Practice Address - Phone:325-356-2571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109959225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist