Allyson Revilla-Jackson, COTA
Individual provider Active NPI Occupational Therapy Assistant · Pinehurst, TX
NPI 1801718408 · NPPES record last updated Jul 27, 2026
Key facts
- NPI
- 1801718408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 219247 (TX)
- Practice address
- 32011 Sue LN
Pinehurst, TX 77362-4083 - Phone
- (361) 562-4779
- NPI assigned
- Jul 27, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 219247 | TX | Yes |
Addresses
Primary practice location
32011 Sue LN
Pinehurst, TX 77362-4083
Mailing address
32011 Sue LN
Pinehurst, TX 77362-4083
Phone (361) 562-4779
Other names
- Allyson Jackson
Other providers in Pinehurst, TX
- Courtney Milburn
- Maulik Nanavati
- T'Iara Ochoa
- Stephanie Michelle Poche
- Kalyani Potluri
- Reagan Reynolds
- Yasmine Rivera
- Kristin Maria Rohlfs Labbie
- Camille Shea
- Doug Simper
All providers in Pinehurst, TX · Occupational Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.