Provider Demographics
NPI:1205368446
Name:CHOI, DESAREE JOY PULVERA
Entity Type:Individual
Prefix:MRS
First Name:DESAREE JOY
Middle Name:PULVERA
Last Name:CHOI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DESAREE
Other - Middle Name:
Other - Last Name:PULVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4818 EAST SAM HOUSTON PKWY N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015
Mailing Address - Country:US
Mailing Address - Phone:713-773-5110
Mailing Address - Fax:
Practice Address - Street 1:4818 EAST SAM HOUSTON PKWY N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015
Practice Address - Country:US
Practice Address - Phone:713-773-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2022-05-24
Deactivation Date:2021-09-23
Deactivation Code:
Reactivation Date:2022-03-04
Provider Licenses
StateLicense IDTaxonomies
FL377714224Z00000X
TXOT122087224Z00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant