Healthcare Provider Details
I. General information
NPI: 1659282457
Provider Name (Legal Business Name): BRENDA LEE FELIX OTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25018 OAKHURST DR
SPRING TX
77386-2722
US
IV. Provider business mailing address
25018 OAKHURST DR
SPRING TX
77386-2722
US
V. Phone/Fax
- Phone: 361-443-8073
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224ZE0001X |
| Taxonomy | Environmental Modification Occupational Therapy Assistant |
| License Number | 210449 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: