Theodore John Mink, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

117753 Issued in TX

Practice address

810 W Highway 71
Marble Falls, TX 78654-8602

Phone

(830) 201-7100

Fax

(830) 201-7143

NPI assigned

Jun 15, 2012

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902168818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W HIGHWAY 71",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786548602",
            "telephone_number": "830-201-7100",
            "fax_number": "830-201-7143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W HIGHWAY 71",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786548602",
            "telephone_number": "830-201-7100",
            "fax_number": "830-201-7143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MA",
            "postal_code": "021485014",
            "country_code": "US",
            "telephone_number": "866-804-4957",
            "fax_number": "866-228-0112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINK",
        "first_name": "THEODORE",
        "middle_name": "JOHN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "6139",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LISCENSE",
            "identifier": "117753",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Anne Meyer, MSN, RN, FNP-BC
• Suzette Mikula
• Kristine S Miller, LMFT
• Shelbi Hope Miller, PA-C
• April Ann Mills, PHARM D
• Lidiore Reignz Acaylar Miranda, PT
• Elizabeth Nicole Mitchell
• Monica Rashell Monasmith
• Adrienne Monroe, PHARMD
• Caden Andrew Moore

• Occupational Therapist in Marble Falls, TX
• Providers in Marble Falls, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.