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Sanami Ann Fottral

Occupational Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

101 W Goodwin Ave Ste 600, Victoria, TX 77901-6530

PECOS Enrollment

Based on the most recent information from CMS, provider Sanami Ann Fottral does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1619459666
Provider Type
Individual
Full Name
Fottral, Sanami Ann
Gender
Female

Sole Proprietor
No
Enumeration Date
9/5/2018
Last Updated
9/5/2018

Contact Information

Practice Location

101 W Goodwin Ave Ste 600, Victoria, TX 77901-6530

(361) 572-0784

Unlisted Fax

Mailing Location

1107 E Quincy St, San Antonio, TX 78212-4517

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 225X00000X Primary	Description Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 114325 Texas

Provider Identifiers

ID	Description	Issuer
ID 114325	Description Other	Issuer N/A Texas

Sanami Ann Fottral

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Hessler, Stephanie M

Bolom, Angie M

Har Even, Kimberly

Zidek, Amber Dawn

Macha, Kylie

Wartsbaugh, Alison Leigh

Kacir, Marjorie W

Boothe, Christina A

Dunn, Amanda Kristin

Sharp, Cameron Lee