Provider Demographics
NPI:1730218108
Name:DREYER, LOUISE PETRA (OTR)
Entity type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:PETRA
Last Name:DREYER
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 1:2109 SAWDUST RD APT 13102
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-5701
Mailing Address - Country:US
Mailing Address - Phone:713-483-4688
Mailing Address - Fax:
Practice Address - Street 1:19073 INTERSTATE 45 S STE 145
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-8744
Practice Address - Country:US
Practice Address - Phone:936-321-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111477225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T6228OtherBLUE CROSS BLUE SHIELD