Individual provider Active NPI

Gilou Cledanor, COTA

  • Occupational Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1720320856
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
211696 Issued in TX
Practice address
3453 I 35
Suite 110
San Antonio, TX 78219
Phone
(210) 226-7767
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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 211696 TX Primary

Addresses

Primary practice location

3453 I 35
Suite 110
San Antonio, TX 78219

Mailing address

3453 I 35
Suite 110
San Antonio, TX 78219
Phone (210) 226-7767

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
211696TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1720320856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3453 I 35",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78219",
            "telephone_number": "210-226-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3453 I 35",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78219",
            "telephone_number": "210-226-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEDANOR",
        "first_name": "GILOU",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.