Active NPI
Jurden Pasilan
- Occupational Therapist
- Winnsboro, TX
National Provider Identifier
1851629612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 113546
- Practice address
- 406 S Main St
Winnsboro, TX 75494-3226 - Phone
- (903) 342-6790
- NPI assigned
- Dec 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 113546 | TX | Primary |
| Gerontology Occupational Therapist | 225XG0600X | 007023 | OH |
Addresses
Primary practice location
406 S Main St
Winnsboro, TX 75494-3226
Mailing address
3715 Colony Park Dr
Tyler, TX 75701-9603
Phone (512) 579-9104
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007023 | OH | MD | Gerontology Occupational Therapist |
| 113546 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1851629612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 COLONY PARK DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757019603",
"telephone_number": "512-579-9104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 S MAIN ST",
"city": "WINNSBORO",
"state": "TX",
"postal_code": "754943226",
"telephone_number": "903-342-6790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASILAN",
"first_name": "JURDEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-04",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "113546",
"primary": true
},
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "OH",
"license": "007023",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnsboro, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.