MEDICARE: LALITA YINDEEMARK OTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER		N/A

General Provider Information

NPI Number	:	1083202568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LALITA YINDEEMARK OTA

Provider Business Mailing Address
First Line	:	7105 OLD KATY RD APT 4403
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2167
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6527 MAPLE DR
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-1405
Country	:	US
Telephone Number	:	281-960-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2021
Last Update Date	:	09/11/2025

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Directions to “ LALITA YINDEEMARK OTA” Practice Location

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