Fabiola Negrete, OT

Individual provider Active NPI Occupational Therapist · Lake Jackson, TX

NPI 1205558137 · NPPES record last updated Oct 6, 2023

Key facts

NPI
1205558137
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
111424 (TX)
Practice address
309 Plantation Dr
Lake Jackson, TX 77566-6142
Phone
(979) 418-7165
Fax
(979) 848-8337
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Univeristy of Texas Rio Grande Valley Med School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Angel Leaf Rehab and Consulting LLC (4 clinicians)

Practice addresses (Care Compare)

309 Plantation Dr
Lake Jackson, TX 77566-6142
Phone (979) 418-7165

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231023002591 TX Practitioner - Occupational Therapist in Private Practice 9133575434 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Leaf Rehab and Consulting LLC Occupational Therapist Current
since Sep 20, 2023
Accepting new patients
Brazoria County Association for Children'S Habilitation Past Accepting new patients

Locations

309 Plantation Dr
Lake Jackson, TX 77566
Phone (979) 418-7165

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 111424 TX Yes

Addresses

Primary practice location

309 Plantation Dr
Lake Jackson, TX 77566-6142

Mailing address

309 Plantation Dr
Lake Jackson, TX 77566-6142
Phone (979) 418-7165

Other providers in Lake Jackson, TX

All providers in Lake Jackson, TX · Occupational Therapist in Texas

Sources for this page

Verify at the official NPI Registry.