Taylor Ashley Azua, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

113356 Issued in TX

Practice address

1200 S Hall St
Ennis, TX 75119-6339

Phone

(512) 789-2806

NPI assigned

Jul 25, 2015

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Taylor Ashley Ivie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1437782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1750766259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3526 KINGS CIR",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751101208",
            "telephone_number": "512-789-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S HALL ST",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751196339",
            "telephone_number": "512-789-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZUA",
        "first_name": "TAYLOR",
        "middle_name": "ASHLEY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-25",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "113356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "IVIE",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Ennis, TX
• Providers in Ennis, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.