Healthcare Provider Details

I. General information

NPI: 1013693498
Provider Name (Legal Business Name): NATASHA CUKU OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATASHA WOYCHUK MAIDEN LAST NAME

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GESSNER RD STE 190
HOUSTON TX
77080-3844
US

IV. Provider business mailing address

2600 GESSNER RD STE 190
HOUSTON TX
77080-3844
US

V. Phone/Fax

Practice location:
  • Phone: 713-996-7996
  • Fax:
Mailing address:
  • Phone: 713-996-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number123394
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: