Active NPI
Eli Samuel Perez Diaz, COTA
- Occupational Therapy Assistant
- San Antonio, TX
National Provider Identifier
1861226581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 217847
- Practice address
- 4949 Ravenswood Dr
San Antonio, TX 78227-4320 - Phone
- (210) 673-2761
- NPI assigned
- Aug 27, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 217847 | TX | Primary |
Addresses
Primary practice location
4949 Ravenswood Dr
San Antonio, TX 78227-4320
Mailing address
4949 Ravenswood Dr
San Antonio, TX 78227-4320
Phone (210) 673-2761
Other names 1
- Eli Samuel Perez
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 |
|---|---|---|---|
| 217847 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1861226581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4949 RAVENSWOOD DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782274320",
"telephone_number": "210-673-2761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4949 RAVENSWOOD DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782274320",
"telephone_number": "210-673-2761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ DIAZ",
"first_name": "ELI",
"middle_name": "SAMUEL",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-27",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "217847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELI",
"last_name": "PEREZ",
"middle_name": "SAMUEL",
"credential": "COTA",
"code": "2",
"type": "Professional Name"
}
]
}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 Aug 27, 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.