Great Minds Academy

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

GREAT MINDS ACADEMY

Practice address

309 Plantation Dr Ste P
Lake Jackson, TX 77566-6142

Phone

(979) 418-7165

Fax

(800) 419-5153

NPI assigned

Jul 18, 2023

Organization subpart

No

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

Authorized official

Name

Edna Lucio, OT

Title

Owner

Phone

(979) 418-7165

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1760162572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 PLANTATION DR STE P",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 PLANTATION DR STE P",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666142",
            "telephone_number": "979-418-7165",
            "fax_number": "800-419-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT MINDS ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "LUCIO",
        "authorized_official_first_name": "EDNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-418-7165",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "officeassistant@angelleaf.net",
            "affiliation": "Y",
            "affiliationName": "Angel Leaf Rehab and Consulting LLC",
            "address_1": "309 Plantation Dr Ste P",
            "city": "Lake Jackson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775666142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeevan Chaythan Gowda, MD
• Jonathan Patrick Grady, M.D.
• Kelly Gragert
• Kathleen Graham, D.D.S.
• Lisa Marie Greak, OT
• Great Minds Academy, LLC
• Karen Renee Gresham, LPC , NCC
• Mario Guel, LPC
• Selena Guerrero
• Jesus Guevara III, LPC

• Pediatric Occupational Therapist in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Pediatric Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.