Individual provider Active NPI

Lily Rose Burgos, COTA

  • Occupational Therapy Assistant
  • Spring, TX
National Provider Identifier
1912720962
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
218090 Issued in TX
Practice address
25018 Oakhurst Dr
Spring, TX 77386-2722
Phone
(888) 364-9695
NPI assigned
Nov 6, 2024
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 218090 TX Primary

Addresses

Primary practice location

25018 Oakhurst Dr
Spring, TX 77386-2722

Mailing address

3240 Poe Dr
Montgomery, TX 77356-5500
Phone (832) 931-3545

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
218090TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder Pediatrics Home Care, LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations

25018 Oakhurst Dr
Spring, TX 77386
Phone (281) 363-1005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1912720962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 POE DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773565500",
            "telephone_number": "832-931-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25018 OAKHURST DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773862722",
            "telephone_number": "888-364-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "LILY",
        "middle_name": "ROSE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "218090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.