Provider Demographics
NPI:1265760961
Name:PATTY, CASEY BYE (OTR)
Entity type:Individual
Prefix:MS
First Name:CASEY
Middle Name:BYE
Last Name:PATTY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9303 CRESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2636
Mailing Address - Country:US
Mailing Address - Phone:214-478-3998
Mailing Address - Fax:
Practice Address - Street 1:5720 LBJ FWY
Practice Address - Street 2:SUITE 550
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6328
Practice Address - Country:US
Practice Address - Phone:972-808-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106676225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist