Individual provider Active NPI

Angelica Estela Leal, MSOT, OTR

  • Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1356099824
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
122570 Issued in TX
Practice address
400 E Quincy St
San Antonio, TX 78215-1934
Phone
(210) 472-0211
NPI assigned
Mar 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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 122570 TX Primary

Addresses

Primary practice location

400 E Quincy St
San Antonio, TX 78215-1934

Mailing address

11031 Geneva Moon
San Antonio, TX 78254-5552
Phone (210) 290-4625

Other names 1

  • Angelica Diaz Former name

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
122570TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1356099824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 GENEVA MOON",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782545552",
            "telephone_number": "210-290-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E QUINCY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151934",
            "telephone_number": "210-472-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAL",
        "first_name": "ANGELICA",
        "middle_name": "ESTELA",
        "credential": "MSOT, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "122570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELICA",
            "last_name": "DIAZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.