Provider Demographics
NPI:1134595838
Name:COLE, ANTONIA FRANCISCA (OTR/L)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:FRANCISCA
Last Name:COLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21801 NORTHCREST DR
Mailing Address - Street 2:APT 1621
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4063
Mailing Address - Country:US
Mailing Address - Phone:832-654-7876
Mailing Address - Fax:
Practice Address - Street 1:5313 DECKER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-1413
Practice Address - Country:US
Practice Address - Phone:281-838-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115773225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist