Provider Demographics
NPI:1639561459
Name:LOMAS, DIANA (COTA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:LOMAS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 COUNTY ROAD 2188D N
Mailing Address - Street 2:
Mailing Address - City:TATUM
Mailing Address - State:TX
Mailing Address - Zip Code:75691-3719
Mailing Address - Country:US
Mailing Address - Phone:903-399-4651
Mailing Address - Fax:
Practice Address - Street 1:298 COUNTY ROAD 2188D N
Practice Address - Street 2:
Practice Address - City:TATUM
Practice Address - State:TX
Practice Address - Zip Code:75691-3719
Practice Address - Country:US
Practice Address - Phone:903-797-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212451224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant