Individual provider Active NPI

Heather Elizabeth O'Brien, OTR

  • Pediatric Occupational Therapist
  • San Antonio, TX
National Provider Identifier
1922110550
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
107536 Issued in TX
Practice address
1248 Austin Hwy Ste 210
San Antonio, TX 78209-4867
Phone
(219) 646-8008
Fax
(210) 646-8242
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 107536 TX Primary
Neurorehabilitation Occupational Therapist 225XN1300X 107536 TX

Addresses

Primary practice location

1248 Austin Hwy Ste 210
San Antonio, TX 78209-4867

Mailing address

1248 Austin Hwy Ste 210
San Antonio, TX 78209-4867
Phone (210) 646-8008

Other identifiers 2

IdentifierTypeStateIssuer
8T0947OtherTXBCBS
75285003678239A007OtherTXTRICARE

Other names 1

  • Ms. Heather O'Brien Tablizo Former name

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
107536TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
S. Potts and Professionals, Inc. Pediatrics CurrentSince Oct 19, 2020 Accepting new patients

Locations

1248 Austin Hwy
Ste 210
San Antonio, TX 78209
Phone (210) 562-0748

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1922110550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 AUSTIN HWY STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094867",
            "telephone_number": "210-646-8008",
            "fax_number": "210-646-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 AUSTIN HWY STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094867",
            "telephone_number": "219-646-8008",
            "fax_number": "210-646-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "107536",
            "primary": true
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "TX",
            "license": "107536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8T0947",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75285003678239A007",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "TABLIZO",
            "middle_name": "O'BRIEN",
            "prefix": "MS.",
            "credential": "OTR",
            "code": "1",
            "type": "Former 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 Oct 21, 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.

Verify at the official NPI Registry.