Provider Demographics
NPI:1033489729
Name:GLAUB, TANJA (OTR)
Entity Type:Individual
Prefix:
First Name:TANJA
Middle Name:
Last Name:GLAUB
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 AIRLINE DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-1959
Mailing Address - Country:US
Mailing Address - Phone:713-691-5437
Mailing Address - Fax:713-691-5445
Practice Address - Street 1:5206 AIRLINE DR
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-1959
Practice Address - Country:US
Practice Address - Phone:713-691-5437
Practice Address - Fax:713-691-5445
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
TX118229225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner