MEDICARE: MRS. LAURIE D MCCORD OTR

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	171W00000X	Contractor	110823	TX
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1548278195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURIE D MCCORD OTR

Provider Business Mailing Address
First Line	:	5210 ABERTON LN
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-6003
Country	:	US
Telephone Number	:	713-807-1131
Fax Number	:	713-807-1141

Provider Business Practice Location Address
First Line	:	1629 W MAIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-4711
Country	:	US
Telephone Number	:	713-807-1131
Fax Number	:	713-807-1141

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	04/13/2023

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