Provider Demographics
NPI:1780204420
Name:OCCUPATIONAL ADVANTAGE
Entity type:Organization
Organization Name:OCCUPATIONAL ADVANTAGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DIONISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREDIA-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:361-537-8463
Mailing Address - Street 1:2035 N MASON RD STE 502
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6879
Mailing Address - Country:US
Mailing Address - Phone:832-680-3561
Mailing Address - Fax:
Practice Address - Street 1:2035 N MASON RD STE 502
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6879
Practice Address - Country:US
Practice Address - Phone:832-680-3561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty