Dickson Innemeset Etukudoh

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

216510 Issued in TX

Practice address

21630 Merchants Way Ste 200
Katy, TX 77449-2514

Phone

(281) 253-6812

NPI assigned

Oct 23, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1144829706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9797 LEAWOOD BLVD APT 608",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992666",
            "telephone_number": "713-538-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21630 MERCHANTS WAY STE 200",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774492514",
            "telephone_number": "281-253-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETUKUDOH",
        "first_name": "DICKSON",
        "middle_name": "INNEMESET",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph C Estes, DDS
• Carmen Elisa Estimbo, MS, LPC
• Carlton George Estler, D.D.S.
• Viviana Estrada-Garcia
• Ruth Estrada, RD, LD
• Lorie Ann Eubank, RMT, MMP
• Natalie Michelle Evans, D.C.
• Shaundaniquea Evans
• Skylar Evans
• Tamiracle Evans

• Occupational Therapy Assistant in Katy, TX
• Providers in Katy, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.