Provider Demographics
NPI:1578262358
Name:PILLEY, STEPHEN CLAYTON (COTA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CLAYTON
Last Name:PILLEY
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 CONRAD CIR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2609
Mailing Address - Country:US
Mailing Address - Phone:817-734-1924
Mailing Address - Fax:
Practice Address - Street 1:3901 KIRKPATRICK LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2005
Practice Address - Country:US
Practice Address - Phone:972-972-9105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217768224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant