Basic Information
| Provider Information | |||||||||
| NPI: | 1275602047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGGINS | ||||||||
| FirstName: | PENNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13618 WOODCHESTER DR | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774782455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812424978 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15400 SOUTHWEST FWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774783876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815658800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
ID Information
| ID | Type | State | Issuer | Description | 202668 | 01 | TX | LICENSE# | OTHER |