Provider Demographics
NPI:1225795404
Name:ISLAM, AISHA SHIRAZ (COTA)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:SHIRAZ
Last Name:ISLAM
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 1:13931 WINDWOOD FALLS LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1583
Mailing Address - Country:US
Mailing Address - Phone:832-878-0728
Mailing Address - Fax:
Practice Address - Street 1:13931 WINDWOOD FALLS LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-1583
Practice Address - Country:US
Practice Address - Phone:832-878-0728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217157224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant