Provider Demographics
NPI:1861927014
Name:DESPOMMIER, JEFFREY (OTR, OMS, CUA, ATP)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:DESPOMMIER
Suffix:
Gender:M
Credentials:OTR, OMS, CUA, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 KIRBY DRIVE SUITE 700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2535
Mailing Address - Country:US
Mailing Address - Phone:832-712-8356
Mailing Address - Fax:
Practice Address - Street 1:9220 KIRBY DRIVE SUITE 700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1939
Practice Address - Country:US
Practice Address - Phone:832-712-8356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112891225X00000X
91056247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist