Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 225XP0200X | Occupational Therapist | Pediatrics | | TEXAS | No |
| 2 | 235Z00000X | Speech-Language Pathologist | | | | Yes |
| 3 | 2251P0200X | Physical Therapist | Pediatrics | | TEXAS | No |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 38332 | OTHER | | BEECHSTREET HMO |
| 2 | NTX11 | OTHER | | NTHN |
| 3 | 61101 | OTHER | | HUMANA |
| 4 | 62308 | OTHER | | CIGNA |
| 5 | 74223 | OTHER | | BENEFIT PLANNERS-PHCS HMO |
| 6 | 87726 | OTHER | | UNITED HEALTHCARE |
| 7 | 39141 | OTHER | | FIRST HEALTH PPO |
| 8 | 87043 | OTHER | | FIRST HEALTH HMO |
| 9 | 95959 | OTHER | | PACIFICARE HMO |
| 10 | 48143 | OTHER | | GROUP AND PENSION |
| 11 | 80705 | OTHER | | ONE HEALTH PLAN |
| 12 | 84146 | OTHER | | CHAMP VA |
| 13 | 87265 | OTHER | | BENESIGHT-UHC HMO |
| 14 | 80314 | OTHER | | UNICARE |
| 15 | 44054 | OTHER | | GEHA-PHCS HMO |
| 16 | 37283 | OTHER | | GALLAGHER BENEFIT ADMIN |
| 17 | 62413 | OTHER | | MAIL HANDLERS BENEFIT PLA |
| 18 | 67466 | OTHER | | PACIFIC LIFE & ANNUITY |
