| Diane Miller Supak, | |
|
457 N Main St, La Grange, TX 78945-1937 | |
| (979) 968-5865 | |
| Not Available |
| Full Name | Diane Miller Supak |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 457 N Main St, La Grange, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356824916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Miller Supak, 481 Fm 2503, Fayetteville, TX 78940-5101 Ph: () - | Diane Miller Supak, 457 N Main St, La Grange, TX 78945-1937 Ph: (979) 968-5865 |
Ms. Teresa Kay Carmack, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: Care Inn Of La Grange, 457 N. Main Street, La Grange, TX 78945 Phone: 979-968-5865 | |
Mrs. Veronica Olivares-garza, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 260 West Live Oak St, La Grange, TX 78945 Phone: 979-968-9394 |