Provider Demographics
NPI:1316415417
Name:HISER, SAVANNA LEE (OTR)
Entity Type:Individual
Prefix:
First Name:SAVANNA
Middle Name:LEE
Last Name:HISER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:LEE
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16311 WOMA CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7635
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15400 SOUTHWEST FWY STE 310
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3875
Practice Address - Country:US
Practice Address - Phone:281-494-7010
Practice Address - Fax:281-494-0038
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist