Individual provider Active NPI

Gonzalo Siqueiros, COTA

  • Occupational Therapy Assistant
  • El Paso, TX
National Provider Identifier
1669258950
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
218041 Issued in TX
Practice address
1351 N Zaragoza Rd BLDG G
El Paso, TX 79936-7902
Phone
(915) 444-0945
NPI assigned
Sep 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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 218041 TX Primary

Addresses

Primary practice location

1351 N Zaragoza Rd BLDG G
El Paso, TX 79936-7902

Mailing address

1643 Dave Elliott Dr
El Paso, TX 79936-5731
Phone (915) 241-1670

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
218041TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1669258950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 DAVE ELLIOTT DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365731",
            "telephone_number": "915-241-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 N ZARAGOZA RD BLDG G",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367902",
            "telephone_number": "915-444-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIQUEIROS",
        "first_name": "GONZALO",
        "name_prefix": "Mr.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "218041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.