RONETTA Y WILKERSON OT NPI 1447540570

NPI Information

NPI: 1447540570
Provider Name: RONETTA Y WILKERSON, OT
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
2425 E SOUTHLAKE BLVD
#100
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 442-0222
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Ronetta Y Wilkerson, OT is a specialist in Southlake, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Ronetta Y Wilkerson, OT NPI is 1447540570. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2425 E SOUTHLAKE BLVD
#100
SOUTHLAKE, TX
ZIP 76092-674
Phone: (817) 442-0222
Fax: (817) 442-0223

The enumeration date for this NPI number is 4/11/2011 and was last updated on 4/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		116083	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	676535	MEDICARE PIN	TEXAS
2	149984001	MEDICAID	TEXAS
3	207164901	MEDICAID	TEXAS
4	456606	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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