Blanca Ivette Manriquez, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

214069 Issued in TX

Practice address

4201 Stonegate Blvd
Fort Worth, TX 76109-9503

Phone

(817) 924-5440

NPI assigned

Aug 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Blanca Ivette Manriquez Professional name

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1952881062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 CLUBGATE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761372928",
            "telephone_number": "915-373-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 STONEGATE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761099503",
            "telephone_number": "817-924-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANRIQUEZ",
        "first_name": "BLANCA",
        "middle_name": "IVETTE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "214069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLANCA",
            "last_name": "MANRIQUEZ",
            "middle_name": "IVETTE",
            "prefix": "MRS.",
            "credential": "COTA/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Samantha Manriquez
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• Mandy Mansell, NP
• Mansfield Non-Emergency Transportation LLC
• Rachel Martha Mansheim, NP

• Occupational Therapy Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.