Healthcare Provider Details

I. General information

NPI: 1922457662
Provider Name (Legal Business Name): JAMIE LYNN KOREY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 06/04/2024
Certification Date: 07/20/2022
Deactivation Date: 07/20/2022
Reactivation Date: 06/04/2024

III. Provider practice location address

2600 GESSNER RD SUITE 190
HOUSTON TX
77080-3839
US

IV. Provider business mailing address

2600 GESSNER RD SUITE 190
HOUSTON TX
77080-3839
US

V. Phone/Fax

Practice location:
  • Phone: 713-996-7996
  • Fax: 713-996-7591
Mailing address:
  • Phone: 713-996-7996
  • Fax: 713-996-7591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number117727
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: