Provider Demographics
NPI:1902640675
Name:BAYLOR, DENISE MICHELE (OTR, CLT-LANA, LMT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MICHELE
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:OTR, CLT-LANA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 EL CAMINO REAL STE 105D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2632
Mailing Address - Country:US
Mailing Address - Phone:281-630-5413
Mailing Address - Fax:281-858-2349
Practice Address - Street 1:17000 EL CAMINO REAL STE 105D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2632
Practice Address - Country:US
Practice Address - Phone:281-630-5413
Practice Address - Fax:281-858-2349
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117170225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist