Active NPI
Maria Guadalupe Ibarra
- Occupational Therapist
- Laredo, TX
National Provider Identifier
1356577639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 111289
- Practice address
- 2335 E Saunders St
Plaza 2
Laredo, TX 78041-5434 - Phone
- (956) 791-4800
- Fax
- (956) 791-4422
- NPI assigned
- Jun 1, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 111289 | TX | Primary |
Addresses
Primary practice location
2335 E Saunders St
Plaza 2
Laredo, TX 78041-5434
Mailing address
2335 E Saunders St
Plaza 2
Laredo, TX 78041-5434
Phone (956) 791-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111289 | Other | TX | STATE LICENSE |
Other names 1
- Maria Guadalupe Roque
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
| License | State | Type | Specialty |
|---|---|---|---|
| 111289 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243814400000",
"number": "1356577639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2335 E SAUNDERS ST",
"address_2": "PLAZA 2",
"city": "LAREDO",
"state": "TX",
"postal_code": "780415434",
"telephone_number": "956-791-4800",
"fax_number": "956-791-4422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2335 E SAUNDERS ST",
"address_2": "PLAZA 2",
"city": "LAREDO",
"state": "TX",
"postal_code": "780415434",
"telephone_number": "956-791-4800",
"fax_number": "956-791-4422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBARRA",
"first_name": "MARIA",
"middle_name": "GUADALUPE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-01",
"last_updated": "2009-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "111289",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "111289",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARIA",
"last_name": "ROQUE",
"middle_name": "GUADALUPE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.