Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 112351 | TX |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 112351 | TX |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 112351 | TX |
NPI | 1942525274 |
---|---|
Provider Name | Lina Ann Thomas |
First Address | Houston, TX 77098-5251 |
Second Address | Houston, TX 77074-5200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 30/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17903620 | (05) | TX |