Active NPI
Charlita Tillman
- Occupational Therapy Assistant
- Houston, TX
National Provider Identifier
1003437815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 212295
- Practice address
- 2000 Holly Hall St
Houston, TX 77054-4032 - Phone
- (713) 799-9031
- NPI assigned
- May 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 212295 | IN | Primary |
Addresses
Primary practice location
2000 Holly Hall St
Houston, TX 77054-4032
Mailing address
20727 Fernwick Village Dr
Cypress, TX 77433-1745
Phone (219) 545-8119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212295 | IN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588550400000",
"number": "1003437815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20727 FERNWICK VILLAGE DR",
"city": "CYPRESS",
"state": "TX",
"postal_code": "774331745",
"telephone_number": "219-545-8119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 HOLLY HALL ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770544032",
"telephone_number": "713-799-9031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "CHARLITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-04",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "212295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.