Individual provider Active NPI

Gayle Tabotabo

  • Occupational Therapist
  • Round Rock, TX
National Provider Identifier
1184138786
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
118189 Issued in TX
Practice address
11 Galloping Rd
Round Rock, TX 78681-4157
Phone
(512) 341-9991
Fax
(512) 341-0019
NPI assigned
Nov 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 118189 TX Primary

Addresses

Primary practice location

11 Galloping Rd
Round Rock, TX 78681-4157

Mailing address

11 Galloping Rd
Round Rock, TX 78681-4157
Phone (512) 341-9991

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
118189TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrescence Occupational Therapy, LLC Occupational Therapist Current Accepting new patients
Round Rock Children'S Therapy Center Past Accepting new patients

Organizations & group practices 2

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": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1184138786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GALLOPING RD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814157",
            "telephone_number": "512-341-9991",
            "fax_number": "512-341-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GALLOPING RD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814157",
            "telephone_number": "512-341-9991",
            "fax_number": "512-341-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOTABO",
        "first_name": "GAYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "118189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.