Provider Demographics
NPI:1861034985
Name:MULLENIX, LINDA ANN (OTR)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:MULLENIX
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3122 PALM ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5985
Mailing Address - Country:US
Mailing Address - Phone:713-240-6226
Mailing Address - Fax:
Practice Address - Street 1:3122 PALM ISLAND CIR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5985
Practice Address - Country:US
Practice Address - Phone:713-240-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103133225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology