Provider Demographics
NPI:1053017228
Name:EVANS, LAUREN MARIE (OTD, OTR)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 BISSONNET ST STE 132
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3000
Mailing Address - Country:US
Mailing Address - Phone:713-592-0209
Mailing Address - Fax:
Practice Address - Street 1:4545 BISSONNET ST STE 132
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3000
Practice Address - Country:US
Practice Address - Phone:713-592-0209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123346225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics