Provider Demographics
NPI:1871006866
Name:CEDILLO, OLANDO (OTR, MOT)
Entity Type:Individual
Prefix:
First Name:OLANDO
Middle Name:
Last Name:CEDILLO
Suffix:
Gender:M
Credentials:OTR, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-4832
Mailing Address - Country:US
Mailing Address - Phone:806-219-0500
Mailing Address - Fax:
Practice Address - Street 1:1628 19TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401-4832
Practice Address - Country:US
Practice Address - Phone:806-219-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118728225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics