Provider Demographics
NPI:1699339028
Name:RULAND, PRESTON RAY (OTR/L)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:RAY
Last Name:RULAND
Suffix:
Gender:M
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 1:9215 GREAT HILLS TRL APT 308
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7150
Mailing Address - Country:US
Mailing Address - Phone:806-626-7607
Mailing Address - Fax:
Practice Address - Street 1:11 GALLOPING RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4157
Practice Address - Country:US
Practice Address - Phone:512-341-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
119762225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist