Provider Demographics
NPI:1598840845
Name:HUDDLESTON, SHAWN (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:HUDDLESTON
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 FAIR POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6653
Mailing Address - Country:US
Mailing Address - Phone:713-817-1960
Mailing Address - Fax:
Practice Address - Street 1:19419 GULF FWY STE 3
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-2809
Practice Address - Country:US
Practice Address - Phone:281-488-2815
Practice Address - Fax:281-488-2844
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105849225X00000X
TX201505177225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist