Provider Demographics
NPI:1689409856
Name:TREVIZO, WENDY JAZMIN (COTA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:JAZMIN
Last Name:TREVIZO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 COYOTE CALL CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-0032
Mailing Address - Country:US
Mailing Address - Phone:832-933-4923
Mailing Address - Fax:
Practice Address - Street 1:5702 COYOTE CALL CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-0032
Practice Address - Country:US
Practice Address - Phone:832-933-4923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218412224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant