MEDICARE: RAYMONDO LORA MOT, OTR/L

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	OT006834	GA
2	225X00000X	Occupational Therapist	120961	TX

General Provider Information

NPI Number	:	1699097840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMONDO LORA MOT, OTR/L

Provider Business Mailing Address
First Line	:	539 W COMMERCE ST # 6328
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:	404-947-1818
Fax Number	:	470-777-2484

Provider Business Practice Location Address
First Line	:	539 W COMMERCE ST # 6328
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-1953
Country	:	US
Telephone Number	:	404-947-1818
Fax Number	:	470-777-2484

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

Provider Enumeration Date	:	02/15/2010
Last Update Date	:	09/19/2025

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