Provider Demographics
NPI:1285052621
Name:BIDDULPH, CAROLYN (OTR)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:BIDDULPH
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 1:800 N WATTERS RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5343
Mailing Address - Country:US
Mailing Address - Phone:469-675-3153
Mailing Address - Fax:469-675-3154
Practice Address - Street 1:800 N WATTERS RD
Practice Address - Street 2:SUITE 150
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5343
Practice Address - Country:US
Practice Address - Phone:469-675-3153
Practice Address - Fax:469-675-3154
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115945225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics