Active NPI
Tonya Michele Dekoker, OTR
- Hand Occupational Therapist
- Longview, TX
National Provider Identifier
1902990468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 110190
- Practice address
- 3202 N 4TH St Ste 101
Longview, TX 75605-5143 - Phone
- (903) 753-6635
- Fax
- (903) 753-1114
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 110190 | TX | Primary |
Addresses
Primary practice location
3202 N 4TH St Ste 101
Longview, TX 75605-5143
Mailing address
3206 N. 4TH Street
Longview, TX 75605
Phone (903) 753-6635
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 |
|---|---|---|---|
| 110190 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Treatment Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Kilgore, TX
- NPI 1023002425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215734400000",
"number": "1902990468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3206 N. 4TH STREET",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "75605",
"telephone_number": "903-753-6635",
"fax_number": "903-753-1114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3202 N 4TH ST STE 101",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756055143",
"telephone_number": "903-753-6635",
"fax_number": "903-753-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEKOKER",
"first_name": "TONYA",
"middle_name": "MICHELE",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2008-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "TX",
"license": "110190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.