Denise Juarez, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

114764 Issued in TX

Practice address

3840 Hulen St
Fort Worth, TX 76107-7277

Phone

(817) 335-3022

NPI assigned

Nov 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Denise Boukouendji Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permian Basin Rehabilitation Center

  • Audiologist
  • Odessa, TX
  • NPI 1992918585
  NPD (past)
• Permian Basin Rehabilitation Center for Crippled Children and Adults

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Odessa, TX
  • NPI 1104958701

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1285030049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N ALLEGHANEY AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614408",
            "telephone_number": "432-332-8244",
            "fax_number": "432-580-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-335-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N Alleghaney Ave",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797614408",
            "country_code": "US",
            "telephone_number": "432-332-8244",
            "fax_number": "432-580-7428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "DENISE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "114764",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "BOUKOUENDJI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JS&H Orthopedic Supply L L C
• JS&H Orthopedic Supply L L C
• JTJ Marketing (JTJ Rehab)
• JTM Rooted in Care LLC
• Amanda Raye Juarez, CPNP-PC
• Jesse Juarez
• Vanessa Juarez
• Victor Joel Juarez, CFLE
• Kaitlin Dinh Phuong Judge, PA-C
• Judith Evans, M.Ed.,LPC,LPCS,PLLC

• Occupational Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.