Active NPI
Kimberly Trevino Olivarez, COTA
- Occupational Therapy Assistant
- McAllen, TX
National Provider Identifier
1104834852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 261QR0400X
- Practice address
- 2109 South K Center Street
McAllen, TX 78503 - Phone
- (956) 688-5515
- Fax
- (956) 686-9277
- NPI assigned
- Aug 4, 2006
- 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 Therapy Assistant | 224Z00000X | 261QR0400X | TX | Primary |
Addresses
Primary practice location
2109 South K Center Street
McAllen, TX 78503
Mailing address
6020 N 29TH Lane
McAllen, TX 78504
Phone (956) 631-6896
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 |
|---|---|---|---|
| 261QR0400X | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104834852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6020 N 29TH LANE",
"city": "MCALLEN",
"state": "TX",
"postal_code": "78504",
"telephone_number": "956-631-6896",
"fax_number": "956-618-2439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 SOUTH K CENTER STREET",
"city": "MCALLEN",
"state": "TX",
"postal_code": "78503",
"telephone_number": "956-688-5515",
"fax_number": "956-686-9277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVAREZ",
"first_name": "KIMBERLY",
"middle_name": "TREVINO",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "261QR0400X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McAllen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.