Individual provider Active NPI

Gayle Sue Fish, LOT

  • Pediatric Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1831361443
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
100498 Issued in TX
Practice address
6655 First Park Ten Blvd
San Antonio, TX 78213-4308
Phone
(210) 737-8090
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 100498 TX Primary

Addresses

Primary practice location

6655 First Park Ten Blvd
San Antonio, TX 78213-4308

Mailing address

6655 First Park 10
San Antonio, TX 78213-4308
Phone (210) 737-8090

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
100498TXMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1831361443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 FIRST PARK 10",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134308",
            "telephone_number": "210-737-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 FIRST PARK TEN BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134308",
            "telephone_number": "210-737-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "GAYLE",
        "middle_name": "SUE",
        "credential": "LOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "100498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.