Provider Demographics
NPI:1962736140
Name:MATRECI, PATRICIA GAYLE (OTR)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GAYLE
Last Name:MATRECI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:MATRECI
Other - Last Name:MCNURLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:3321 RILEY DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5361
Mailing Address - Country:US
Mailing Address - Phone:214-552-0310
Mailing Address - Fax:
Practice Address - Street 1:1441 COIT RD
Practice Address - Street 2:SUITE C
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7768
Practice Address - Country:US
Practice Address - Phone:972-867-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist