Provider Demographics
NPI:1215634977
Name:PIVOT TRW
Entity type:Organization
Organization Name:PIVOT TRW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:832-707-4258
Mailing Address - Street 1:6703 BETHUNE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1821
Mailing Address - Country:US
Mailing Address - Phone:832-707-4258
Mailing Address - Fax:
Practice Address - Street 1:6703 BETHUNE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1821
Practice Address - Country:US
Practice Address - Phone:832-707-4258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty