Individual provider Active NPI

Juan E. Perez, COTA

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1104092121
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
121433 Issued in TX
Practice address
102 Palo Alto Rd Ste 120
San Antonio, TX 78211-3773
Phone
(210) 922-1785
Fax
(210) 922-1782
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X
Occupational Therapist 225X00000X 121433 TX Primary

Addresses

Primary practice location

102 Palo Alto Rd Ste 120
San Antonio, TX 78211-3773

Mailing address

102 Palo Alto Rd Ste 120
San Antonio, TX 78211-3773
Phone (210) 922-1785

Other identifiers 1

IdentifierTypeStateIssuer
430378601MedicaidTX

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
121433TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
High Five Rehab LLC Current Accepting new patients
High Five Rehab LLC Occupational Therapist Current Accepting new patients
Magical Kids Therapy Past Accepting new patients

Locations

102 Palo Alto Rd
Ste 120
San Antonio, TX 78211
Phone (210) 818-2210

Organizations & group practices 3

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1104092121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PALO ALTO RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113773",
            "telephone_number": "210-922-1785",
            "fax_number": "210-922-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PALO ALTO RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113773",
            "telephone_number": "210-922-1785",
            "fax_number": "210-922-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JUAN",
        "middle_name": "E.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "121433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430378601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.