Individual provider Active NPI

Richard Graham Nobles, C.O.T.A.

  • Occupational Therapy Assistant
  • Denison, TX
National Provider Identifier
1558664136
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
206219 Issued in TX
Practice address
603 E US Hwy 69
Denison, TX 75020
Phone
(903) 465-2348
NPI assigned
Dec 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 206219 TX Primary

Addresses

Primary practice location

603 E US Hwy 69
Denison, TX 75020

Mailing address

321 Friar Tuck Dr
Gordonville, TX 76245-5745
Phone (903) 818-6353

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
206219TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1558664136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 FRIAR TUCK DR",
            "city": "GORDONVILLE",
            "state": "TX",
            "postal_code": "762455745",
            "telephone_number": "903-818-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E US HWY 69",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "75020",
            "telephone_number": "903-465-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "RICHARD",
        "middle_name": "GRAHAM",
        "credential": "C.O.T.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "206219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.