Provider Demographics
NPI:1982829883
Name:DAVENPORT, PEARL ARNOLD (OT)
Entity Type:Individual
Prefix:
First Name:PEARL
Middle Name:ARNOLD
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 BISSONNET ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3120
Mailing Address - Country:US
Mailing Address - Phone:713-838-9050
Mailing Address - Fax:713-838-0926
Practice Address - Street 1:4500 BISSONNET ST
Practice Address - Street 2:SUITE 340
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3120
Practice Address - Country:US
Practice Address - Phone:713-838-9050
Practice Address - Fax:713-838-0926
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100102225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T2733OtherBCBS