Individual provider Active NPI

Christine Alexis Mendoza, COTA

  • Occupational Therapy Assistant
  • Missouri City, TX
National Provider Identifier
1790400026
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
217612 Issued in TX
Practice address
4722 Riverstone Blvd Ste 100
Missouri City, TX 77459-4723
Phone
(817) 984-8655
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 217612 TX Primary

Addresses

Primary practice location

4722 Riverstone Blvd Ste 100
Missouri City, TX 77459-4723

Mailing address

9634 Jeske Rd
Needville, TX 77461-7207
Phone (832) 535-6758

Other practice location 1

1421 Fm 359 Rd
Richmond, TX 77406-2023
Phone (281) 232-1900

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
217612TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Therapy Plus, PLLC PastSince Oct 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1790400026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9634 JESKE RD",
            "city": "NEEDVILLE",
            "state": "TX",
            "postal_code": "774617207",
            "telephone_number": "832-535-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4722 RIVERSTONE BLVD STE 100",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594723",
            "telephone_number": "817-984-8655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1421 Fm 359 Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774062023",
            "country_code": "US",
            "telephone_number": "281-232-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "CHRISTINE",
        "middle_name": "ALEXIS",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "217612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.