Provider Demographics
NPI:1235609967
Name:ENGLERT, ELIZABETH G (COTA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:ENGLERT
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 1:13402 INDIGO TRACE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3460
Mailing Address - Country:US
Mailing Address - Phone:832-731-5421
Mailing Address - Fax:
Practice Address - Street 1:13402 INDIGO TRACE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3460
Practice Address - Country:US
Practice Address - Phone:832-731-5421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215393224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant