Brooksie Edquist, PT

Individual provider Active NPI Occupational Therapist · Lake Jackson, TX

NPI 1669604591 · NPPES record last updated Aug 11, 2009

Key facts

NPI
1669604591
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
100460 (TX)
Practice address
321 Garland Dr
Lake Jackson, TX 77566-6238
Phone
(979) 297-3365
Fax
(979) 297-3541
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
100460TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brazosport Rehabilitation & Wellness, LLC Occupational Therapist Past
since Apr 18, 2008
Accepting new patients
Fitness & Rehabilitation Services, LLC Occupational Therapist Past Accepting new patients
Brazoria County Association for Children'S Habilitation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 100460 TX Yes

Addresses

Primary practice location

321 Garland Dr
Lake Jackson, TX 77566-6238

Mailing address

321 Garland Dr
Lake Jackson, TX 77566-6238
Phone (979) 297-3365

Other providers in Lake Jackson, TX

All providers in Lake Jackson, TX · Occupational Therapist in Texas

Sources for this page

Verify at the official NPI Registry.