Provider Demographics
NPI:1720309867
Name:AMIS, ELIZABETH (OTR)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:AMIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MEADOWBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4824
Mailing Address - Country:US
Mailing Address - Phone:214-578-5795
Mailing Address - Fax:
Practice Address - Street 1:7710 MEADOWBRIAR LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-4824
Practice Address - Country:US
Practice Address - Phone:214-578-5795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113669225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics