MEDICARE: LAUREN LETSOS

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	115997	TX

General Provider Information

NPI Number	:	1992121214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN LETSOS

Provider Business Mailing Address
First Line	:	14406 BRUSHY ARBOR LN
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4351
Country	:	US
Telephone Number	:	281-687-3759
Fax Number	:

Provider Business Practice Location Address
First Line	:	4142 VALLEY HAVEN DR
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-1953
Country	:	US
Telephone Number	:	713-254-5541
Fax Number	:

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

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	08/22/2016

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Directions to “ LAUREN LETSOS ” Practice Location

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