Active NPI
Victor Iracheta, COTA
- Occupational Therapist
- Corpus Christi, TX
National Provider Identifier
1528548237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 210466
- Practice address
- 3030 Fig St
Corpus Christi, TX 78404-3834 - Phone
- (361) 888-5619
- Fax
- (361) 888-5819
- NPI assigned
- Aug 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 210466 | TX | |
| Occupational Therapist | 225X00000X | 210466 | TX | Primary |
Addresses
Primary practice location
3030 Fig St
Corpus Christi, TX 78404-3834
Mailing address
3030 Fig St
Corpus Christi, TX 78404-3834
Phone (361) 888-5619
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 |
|---|---|---|---|
| 210466 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534809600000",
"number": "1528548237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 FIG ST",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784043834",
"telephone_number": "361-888-5619",
"fax_number": "361-888-5819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 FIG ST",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784043834",
"telephone_number": "361-888-5619",
"fax_number": "361-888-5819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRACHETA",
"first_name": "VICTOR",
"name_prefix": "Mr.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-21",
"last_updated": "2018-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "210466",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "210466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.