Edward Mark Favela Jr., COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5202008595 Issued in MI

Practice address

1514 N Zaragoza Rd Ste B4
El Paso, TX 79936-8041

Phone

(915) 257-5782

NPI assigned

Jul 5, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Early Bird Pediatric Therapy Clinic, Inc

  • Rehabilitation Clinic/Center
  • El Paso, TX
  • NPI 1639538077
  NPD (past)

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1164084620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 N ZARAGOZA RD STE B4",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799368041",
            "telephone_number": "915-257-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 N ZARAGOZA RD STE B4",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799368041",
            "telephone_number": "915-257-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVELA",
        "first_name": "EDWARD",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-05",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202008595",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "215683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fatima T. Garces
• Talyssa Mornei Faulkner
• Valerie Crystal Favela-Portillo, DPT
• Elizabeth Favela-Tomlinson, SLPA
• Celina Favela
• Graciela Favela
• Ingrid Irasema Favela
• Margarita Favela, FNP-C
• Mariaitzel Favela, LPC
• Samuel Humberto Favela Jr., O.D.

• Occupational Therapy Assistant in El Paso, TX
• Providers in El Paso, 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 Jul 8, 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.