Provider Demographics
NPI:1891236824
Name:DAVIS-COLLINS, LERCIA (COTA)
Entity Type:Individual
Prefix:
First Name:LERCIA
Middle Name:
Last Name:DAVIS-COLLINS
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 1:22311 LAMASTER LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8056
Mailing Address - Country:US
Mailing Address - Phone:346-330-2493
Mailing Address - Fax:346-332-0858
Practice Address - Street 1:22311 LAMASTER LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8056
Practice Address - Country:US
Practice Address - Phone:346-330-2493
Practice Address - Fax:346-332-0858
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210698224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX311679605Medicare PIN