Individual provider Active NPI

Fabiola Beltran, OTA, COTA

  • Occupational Therapy Assistant
  • Fort Worth, TX
National Provider Identifier
1053010306
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
217769 Issued in TX
Practice address
4775 North Fwy
Fort Worth, TX 76106-2300
Phone
(682) 738-3056
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 217769 TX Primary

Addresses

Primary practice location

4775 North Fwy
Fort Worth, TX 76106-2300

Mailing address

2516 Winter Oak St
Dallas, TX 75227-7658
Phone (214) 664-7765

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

LicenseStateTypeSpecialty
217769TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Small Hands Big Hearts Pediatric Therapy Management Inc CurrentSince Jul 21, 2024 Accepting new patients

Locations

4775 North Fwy
Fort Worth, TX 76106
Phone (682) 738-3056

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1053010306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 WINTER OAK ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752277658",
            "telephone_number": "214-664-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 NORTH FWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761062300",
            "telephone_number": "682-738-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "FABIOLA",
        "credential": "OTA, COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "217769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.