Healthcare Provider Details

I. General information

NPI: 1902013287
Provider Name (Legal Business Name): JANA LEIJA LOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 HUNT RD
BAYTOWN TX
77521-1599
US

IV. Provider business mailing address

10450 ANTRIM LN.
LA PORTE TX
77571
US

V. Phone/Fax

Practice location:
  • Phone: 832-572-5617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number104048
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: