Provider Demographics
NPI:1073000329
Name:KALATHOOR, LINY JOSEPH (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LINY
Middle Name:JOSEPH
Last Name:KALATHOOR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LINY
Other - Middle Name:KOTHUMPUCHIRA
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:6514 NICHOLAS TRL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4732
Mailing Address - Country:US
Mailing Address - Phone:832-372-4788
Mailing Address - Fax:
Practice Address - Street 1:6400 OILFIELD RD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-9622
Practice Address - Country:US
Practice Address - Phone:832-564-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-21
Last Update Date:2018-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist