Basic Information
Provider Information
NPI: 1861071086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARNOLD
FirstName: CAISEY
MiddleName: LYNNE
NamePrefix:  
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 NE LOOP 820 STE 200
Address2:  
City: HURST
State: TX
PostalCode: 760537211
CountryCode: US
TelephoneNumber: 8172928787
FaxNumber: 8177896849
Practice Location
Address1: 9330 BROADWAY ST STE 312
Address2:  
City: PEARLAND
State: TX
PostalCode: 775847895
CountryCode: US
TelephoneNumber: 8328566241
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/05/2021
LastUpdateDate: 04/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X121726TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


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