Maxwell James Arbor, OTR

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

118563 Issued in TX

Practice address

4681 College Park Dr
Round Rock, TX 78665-1526

Phone

(512) 671-1100

NPI assigned

Sep 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maxwell James Lustick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1750160941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 BANDICE LN",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786605554",
            "telephone_number": "314-315-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4681 COLLEGE PARK DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651526",
            "telephone_number": "512-671-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786651032",
            "country_code": "US",
            "telephone_number": "512-509-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARBOR",
        "first_name": "MAXWELL",
        "middle_name": "JAMES",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "TX",
            "license": "118563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXWELL",
            "last_name": "LUSTICK",
            "middle_name": "JAMES",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Rehabilitation Occupational Therapist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physical Rehabilitation Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.