Provider Demographics
NPI:1285370585
Name:LITTLE PINES PEDIATRIC THERAPY PLLC
Entity type:Organization
Organization Name:LITTLE PINES PEDIATRIC THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:EIZEMBER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/MOT
Authorized Official - Phone:956-292-1394
Mailing Address - Street 1:121 DICKENSON LN
Mailing Address - Street 2:
Mailing Address - City:PAIGE
Mailing Address - State:TX
Mailing Address - Zip Code:78659-4967
Mailing Address - Country:US
Mailing Address - Phone:956-292-1394
Mailing Address - Fax:
Practice Address - Street 1:121 DICKENSON LN
Practice Address - Street 2:
Practice Address - City:PAIGE
Practice Address - State:TX
Practice Address - Zip Code:78659-4967
Practice Address - Country:US
Practice Address - Phone:956-292-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty