Provider Demographics
NPI:1558837435
Name:QUINNEY, VINCENT RAYMONT (OTR)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:RAYMONT
Last Name:QUINNEY
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 AUBURN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2195
Mailing Address - Country:US
Mailing Address - Phone:318-792-2657
Mailing Address - Fax:
Practice Address - Street 1:4006 VISTA RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2112
Practice Address - Country:US
Practice Address - Phone:713-943-1592
Practice Address - Fax:713-943-2770
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111507225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist