Active NPI
Gabrielle Matlack
- Occupational Therapist
- Pasadena, TX
National Provider Identifier
1083395669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 123750
- Practice address
- 4500 E Sam Houston Pkwy S Ste 215
Pasadena, TX 77505-3957 - Phone
- (281) 487-2786
- NPI assigned
- Jul 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225X00000X | 123750 | TX | Primary |
Addresses
Primary practice location
4500 E Sam Houston Pkwy S Ste 215
Pasadena, TX 77505-3957
Mailing address
1201 Enterprise Ave Apt 643
League City, TX 77573-2985
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1083395669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 ENTERPRISE AVE APT 643",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775732985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 E SAM HOUSTON PKWY S STE 215",
"city": "PASADENA",
"state": "TX",
"postal_code": "775053957",
"telephone_number": "281-487-2786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLACK",
"first_name": "GABRIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-27",
"last_updated": "2023-07-27",
"certification_date": "2023-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "123750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.