Provider Demographics
NPI:1487309647
Name:DELAROSA, ALLAN OSCAR (COTA)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:OSCAR
Last Name:DELAROSA
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 MUSKET RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-6835
Mailing Address - Country:US
Mailing Address - Phone:713-398-5597
Mailing Address - Fax:
Practice Address - Street 1:1500 SUNSET DR
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4724
Practice Address - Country:US
Practice Address - Phone:281-992-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212359224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant