Organization
GREAT MINDS ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA LUCIO OT (OWNER)
(979) 418-7165
Entity
Organization
Contact information
Practice address
309 PLANTATION DR STE P, LAKE JACKSON, TX 77566-6142
(979) 418-7165
(800) 419-5153
Mailing address
309 PLANTATION DR STE P, LAKE JACKSON, TX 77566-6142
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
11/21/2023
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