Elizabeth Balderas

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1473 Issued in AR

Practice address

2107 Dudley St
Texarkana, AR 71854-6345

Phone

(870) 772-4427

NPI assigned

Apr 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Quiroz Other 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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1962084731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 KORNEGAY RD",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718328663",
            "telephone_number": "870-613-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 DUDLEY ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718546345",
            "telephone_number": "870-772-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERAS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "215608",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "QUIROZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Debbie J Autrey, MA
• Symone Autrey
• Raven Shelby Ayers, PA-C
• Candace L Baird, APRN, FNP-C
• Paul D. Baker, D.C.
• Byron K Banks, LPE
• Amy Rebecca Barfield, DDS
• Jody A Barham, APN
• Dianna Sharae Barnes, FNP-C
• Robin Janelle Barnes, LCSW

• All providers in Texarkana, AR
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.