Provider Demographics
NPI:1003560780
Name:WALDROP, LAUREN ALISE (COTA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALISE
Last Name:WALDROP
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 CEDARMONT DR
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-4022
Mailing Address - Country:US
Mailing Address - Phone:832-495-3617
Mailing Address - Fax:
Practice Address - Street 1:3333 BAYSHORE BLVD STE 340
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1960
Practice Address - Country:US
Practice Address - Phone:713-910-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217278224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant