Healthcare Provider Details

I. General information

NPI: 1386723401
Provider Name (Legal Business Name): JAYSHREE LEENA SHETH OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 NASA PARKWAY
HOUSTON TX
77058-3304
US

IV. Provider business mailing address

1210 NASA PARKWAY
HOUSTON TX
77058-3304
US

V. Phone/Fax

Practice location:
  • Phone: 281-333-1377
  • Fax: 281-333-0442
Mailing address:
  • Phone: 281-333-1377
  • Fax: 281-333-0442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number101491
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: