Provider Demographics
NPI:1194112730
Name:MOFFITT-SCOTT, VERA S (OTR, RN)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:S
Last Name:MOFFITT-SCOTT
Suffix:
Gender:F
Credentials:OTR, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10851 W MONTFAIR BLVD
Mailing Address - Street 2:APT 3211
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2925
Mailing Address - Country:US
Mailing Address - Phone:813-766-9746
Mailing Address - Fax:
Practice Address - Street 1:2100 WEST LOOP S
Practice Address - Street 2:SUITE 1525
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3515
Practice Address - Country:US
Practice Address - Phone:866-880-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX871867163W00000X
FLRN9398836163W00000X
TX111912225X00000X
FLOT5941225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No163W00000XNursing Service ProvidersRegistered Nurse