Healthcare Provider Details

I. General information

NPI: 1154834919
Provider Name (Legal Business Name): FORAM DESAI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E SAM HOUSTON PKWY S STE 215
PASADENA TX
77505-3957
US

IV. Provider business mailing address

4500 E SAM HOUSTON PKWY S STE 215
PASADENA TX
77505-3957
US

V. Phone/Fax

Practice location:
  • Phone: 281-487-2786
  • Fax:
Mailing address:
  • Phone: 281-487-2786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT17119
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number118005
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: