Provider Demographics
NPI:1891584512
Name:THOMAS, SHEMA KOTTAYADIYIL (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:SHEMA
Middle Name:KOTTAYADIYIL
Last Name:THOMAS
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-4840
Mailing Address - Country:US
Mailing Address - Phone:469-939-1789
Mailing Address - Fax:
Practice Address - Street 1:3605 YUCCA DR STE 102
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2753
Practice Address - Country:US
Practice Address - Phone:972-874-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125345225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist