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General NPI Number Information
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NPI Number | 1174607469
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Entity Type | Individual
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Provider Name | DIANE LYNN BROCATO OCCUPATIONAL THERAPI
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 5810 E SAM HOUSTON PKWY N STE K
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City | HOUSTON
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State | TX
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Zip | 77049-2528
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Country | US
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Telephone | 281-459-9134
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Fax | 281-459-9136
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Provider Business Mailing Address
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Address Line | 19810 OAK GREEN CT
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City | HUMBLE
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State | TX
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Zip | 77346-1273
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Country | US
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Telephone | 281-812-4170
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Fax | 281-459-9136
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 107951
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License Number State | TX
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