Provider Demographics
NPI:1275931313
Name:DANIEL, CATHERINE (LOTA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LOTA
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LOTA
Mailing Address - Street 1:11502 ESPERANZA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-4336
Mailing Address - Country:US
Mailing Address - Phone:512-632-0605
Mailing Address - Fax:
Practice Address - Street 1:305 NE LOOP 280
Practice Address - Street 2:BUSINESS TOWER 1 SUITE 200
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053
Practice Address - Country:US
Practice Address - Phone:817-292-8787
Practice Address - Fax:817-789-6849
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210424224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant