Stephanie Goodman

Individual provider Active NPI Pediatric Occupational Therapist · Cuero, TX

NPI 1043713274 · NPPES record last updated Apr 13, 2022

Key facts

NPI
1043713274
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
Practice address
114 W Main St
Cuero, TX 77954-3736
Phone
(210) 215-3190
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X Yes

Addresses

Primary practice location

114 W Main St
Cuero, TX 77954-3736

Mailing address

8064 US Highway 183 S
Cuero, TX 77954-5518

Other identifiers

IdentifierTypeStateIssuer
14226873MedicaidTX

Electronic endpoints

TypeEndpointUseAffiliation
Other URL HummingbirdOT.com/http

Other providers in Cuero, TX

All providers in Cuero, TX · Pediatric Occupational Therapist in Texas

Sources for this page

Verify at the official NPI Registry.