Provider Demographics
NPI:1669561387
Name:LUJAN, DEANNE J I (COTA)
Entity type:Individual
Prefix:MS
First Name:DEANNE
Middle Name:J
Last Name:LUJAN
Suffix:I
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4701 WESTGATE BLVD
Mailing Address - Street 2:C-301
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1467
Mailing Address - Country:US
Mailing Address - Phone:512-892-7900
Mailing Address - Fax:512-280-9298
Practice Address - Street 1:4701 WESTGATE BLVD
Practice Address - Street 2:C-301
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1467
Practice Address - Country:US
Practice Address - Phone:512-892-7900
Practice Address - Fax:512-280-9298
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209461224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant