Provider Demographics
NPI:1285763243
Name:PERKINS, LAURA ANN (COTA)
Entity type:Individual
Prefix:
First Name:LAURA ANN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 E RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4638
Mailing Address - Country:US
Mailing Address - Phone:512-921-0317
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:2700 SUNRISE RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-9323
Practice Address - Country:US
Practice Address - Phone:610-991-2034
Practice Address - Fax:610-438-2046
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208545OtherECPTOTE
TX676554Medicare Oscar/Certification
TX676626Medicare Oscar/Certification
TX676600Medicare Oscar/Certification
TX676555Medicare Oscar/Certification
TX00936XMedicare ID - Type UnspecifiedPART B GROUP NUMBER
TX676559Medicare Oscar/Certification