MEDICARE: PIVOT TRW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225XP0200X	Pediatric Occupational Therapist
2	224Z00000X	Occupational Therapy Assistant
3	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1215634977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIVOT TRW

Provider Business Mailing Address
First Line	:	6703 BETHUNE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-1821
Country	:	US
Telephone Number	:	832-707-4258
Fax Number	:

Provider Business Practice Location Address
First Line	:	6703 BETHUNE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-1821
Country	:	US
Telephone Number	:	832-707-4258
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	SABRINA STARKS
Credential	:	OTR
Telephone Number	:	832-707-4258

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	06/09/2024

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Directions to “PIVOT TRW ” Practice Location

Language	Start Address	Practice Location

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