Provider Demographics
NPI:1720979578
Name:MOORE, KATHRYN NOEL (COTA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:NOEL
Last Name:MOORE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:502 S POST OAK LN APT 333
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1461
Mailing Address - Country:US
Mailing Address - Phone:346-434-6277
Mailing Address - Fax:
Practice Address - Street 1:6336 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1750
Practice Address - Country:US
Practice Address - Phone:713-423-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218789224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant