Provider Demographics
NPI:1316211121
Name:OICATA, NANCY MAIBE
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MAIBE
Last Name:OICATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2504
Mailing Address - Country:US
Mailing Address - Phone:832-339-1544
Mailing Address - Fax:
Practice Address - Street 1:2900 WOODRIDGE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-6287
Practice Address - Country:US
Practice Address - Phone:832-339-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35912172V00000X
TX113294235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No172V00000XOther Service ProvidersCommunity Health Worker