MEDICARE: MS. LAMIKA L IRUKE OTR

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	225X00000X	Occupational Therapist	111335	TX

General Provider Information

NPI Number	:	1285663831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAMIKA L IRUKE OTR

Provider Business Mailing Address
First Line	:	2509 ROSE BAY DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3451
Country	:	US
Telephone Number	:	713-340-0788
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 S BRAESWOOD BLVD
Second Line	:	SUITE 220
City	:	HOUSTON
State	:	TX
Zip	:	77025-2827
Country	:	US
Telephone Number	:	855-457-6360
Fax Number	:

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/16/2013

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