Provider Demographics
NPI:1790805299
Name:PINEDA, DENISE LOURDES (COTA)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LOURDES
Last Name:PINEDA
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 1:10618 THUNDERHEAD CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-8865
Mailing Address - Country:US
Mailing Address - Phone:561-676-9900
Mailing Address - Fax:
Practice Address - Street 1:1003 N DAVIS AVE
Practice Address - Street 2:APT. 15
Practice Address - City:CAMERON
Practice Address - State:TX
Practice Address - Zip Code:76520-2003
Practice Address - Country:US
Practice Address - Phone:254-605-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209305224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant