MEDICARE: COLLAB THERAPEUTIC SERVICES LLC

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1457207565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLAB THERAPEUTIC SERVICES LLC

Provider Business Mailing Address
First Line	:	5907 NINE MILE LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2590
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5907 NINE MILE LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2590
Country	:	US
Telephone Number	:	914-564-6550
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. PHINCY THOMAS
Credential	:
Telephone Number	:	914-564-6550

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “COLLAB THERAPEUTIC SERVICES LLC ” Practice Location

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