Provider Demographics
NPI:1285663831
Name:IRUKE, LAMIKA L (OTR)
Entity Type:Individual
Prefix:MS
First Name:LAMIKA
Middle Name:L
Last Name:IRUKE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LAMIKA
Other - Middle Name:L
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2509 ROSE BAY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3451
Mailing Address - Country:US
Mailing Address - Phone:713-340-0788
Mailing Address - Fax:
Practice Address - Street 1:2555 S BRAESWOOD BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-2827
Practice Address - Country:US
Practice Address - Phone:855-457-6360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111335225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00930003Medicare PIN
MIP00930003Medicare ID - Type Unspecified