MEDICARE: DEVIN LLOYD OTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	213409	TX

General Provider Information

NPI Number	:	1093487233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVIN LLOYD OTA

Provider Business Mailing Address
First Line	:	11902 RESOURCE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6086
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 PINE MOSS CT
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77581-8820
Country	:	US
Telephone Number	:	409-354-3461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2021
Last Update Date	:	10/07/2021

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Directions to “ DEVIN LLOYD OTA” Practice Location

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