Healthcare Provider Details

I. General information

NPI: 1831061209
Provider Name (Legal Business Name): ANNA LUEDTKE OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 N CAPITAL OF TEXAS HWY STE 200
AUSTIN TX
78759-7234
US

IV. Provider business mailing address

1101 CATTAIL LN
BASTROP TX
78602-2276
US

V. Phone/Fax

Practice location:
  • Phone: 512-372-1035
  • Fax:
Mailing address:
  • Phone: 205-790-3497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number121441
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: