Active NPI
Gabriel Alcorn, OT
- Pediatric Occupational Therapist
- Grand Prairie, TX
National Provider Identifier
1558149484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 123888
- Practice address
- 5143 Balmoral CT
Grand Prairie, TX 75052-2566 - Phone
- (469) 585-3773
- NPI assigned
- Sep 20, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 123888 | TX | Primary |
Addresses
Primary practice location
5143 Balmoral CT
Grand Prairie, TX 75052-2566
Mailing address
5143 Balmoral CT
Grand Prairie, TX 75052-2566
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 |
|---|---|---|---|
| 123888 | TX | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1558149484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5143 BALMORAL CT",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750522566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5143 BALMORAL CT",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750522566",
"telephone_number": "469-585-3773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALCORN",
"first_name": "GABRIEL",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TX",
"license": "123888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.