Provider Demographics
NPI:1902317183
Name:PADILLA MELENDEZ, JENNIFER NAHIR (OTR, OTD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NAHIR
Last Name:PADILLA MELENDEZ
Suffix:
Gender:F
Credentials:OTR, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 WATFORD DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7152
Mailing Address - Country:US
Mailing Address - Phone:409-996-6423
Mailing Address - Fax:
Practice Address - Street 1:6226 WATFORD DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7152
Practice Address - Country:US
Practice Address - Phone:409-998-0388
Practice Address - Fax:409-299-3131
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115686225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist