Provider Demographics
NPI:1215650643
Name:FACUNDO, SABRINA (OTR/L)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:FACUNDO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 BEE CAVES RD STE 206
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5552
Mailing Address - Country:US
Mailing Address - Phone:512-284-8964
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVES RD STE 206
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5552
Practice Address - Country:US
Practice Address - Phone:512-284-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123045225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist