Individual provider Active NPI

Evelyn Bruno Porter

  • Driving and Community Mobility Occupational Therapy Assistant
  • Pearland, TX
National Provider Identifier
1689325458
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Driving and Community Mobility Occupational Therapy AssistantTaxonomy code 224ZR0403X
License
115392 Issued in TX
Practice address
2011 Broadway St
Pearland, TX 77581-5797
Phone
(281) 997-8509
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driving and Community Mobility Occupational Therapy Assistant 224ZR0403X 115392 TX Primary

Addresses

Primary practice location

2011 Broadway St
Pearland, TX 77581-5797

Mailing address

2217 Saint James PL
Pearland, TX 77581-4588
Phone (281) 414-9884

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
115392TXMDDriving and Community Mobility Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1689325458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 SAINT JAMES PL",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775814588",
            "telephone_number": "281-414-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BROADWAY ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815797",
            "telephone_number": "281-997-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "EVELYN",
        "middle_name": "BRUNO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Driving and Community Mobility",
            "state": "TX",
            "license": "115392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.