Individual
MR. JARVIS DEVAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
4423 SHADOWDALE DR, HOUSTON, TX 77041-8718
(713) 466-6872
(713) 466-9547
Mailing address
4423 SHADOWDALE DR, HOUSTON, TX 77041-8718
(713) 466-6872
(713) 466-9547
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
116054
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116054
OT LICENSE NUMBER
TX
Enumeration date
05/15/2014
Last updated
05/15/2014
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