National Provider Identifier

Great Minds Academy

Great Minds Academy is listed in the NPPES registry with a primary specialty of Pediatric Occupational Therapist in Lake Jackson, TX and a listed phone number of (979) 418-7165.

NPI 1760162572Lake Jackson, TXPediatric Occupational Therapist

Source: public NPPES record, last updated November 21, 2023. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1760162572
Provider Type
Organization
Primary Specialty
Pediatric Occupational Therapist
Enumeration Date
July 18, 2023
Last Updated
November 21, 2023

Practice Location

  • 309 Plantation Dr Ste P
  • Lake Jackson, TX 77566-6142

Phone: (979) 418-7165

Authorized Official

Name
Edna Lucio
Title
Owner
Credentials
OT
Phone
(979) 418-7165

Specialties

  • Pediatric Occupational Therapist (225XP0200X)
  • Pediatric Physical Therapist (2251P0200X)

Endpoints

  • officeassistant@angelleaf.net

    Direct Messaging Address | Angel Leaf Rehab And Consulting LLC | Lake Jackson, TX 77566

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Full Record
NPI
1760162572
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Great Minds Academy
Mailing Street Address
309 Plantation Dr Ste P
Mailing City
Lake Jackson
Mailing State
TX
Mailing ZIP Code
77566-6142
Mailing Country
US
Practice Street Address
309 Plantation Dr Ste P
Practice City
Lake Jackson
Practice State
TX
Practice ZIP Code
77566-6142
Practice Country
US
Practice Phone
(979) 418-7165
Practice Fax
(800) 419-5153
Enumeration Date
July 18, 2023
Last Updated
November 21, 2023
Authorized Official Last Name
Lucio
Authorized Official First Name
Edna
Authorized Official Title
Owner
Authorized Official Phone
(979) 418-7165
Organization Subpart
No
Authorized Official Credential Text
OT
Taxonomy Group 1
193200000X Multi-Specialty Group
Taxonomy Group 2
193200000X Multi-Specialty Group
Certification Date
November 21, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatric Occupational Therapist (225XP0200X), Pediatric Physical Therapist (2251P0200X)