Provider Demographics
NPI:1689073298
Name:RINEY, CARI ANN GOODYEAR (MOTR/L)
Entity type:Individual
Prefix:
First Name:CARI ANN
Middle Name:GOODYEAR
Last Name:RINEY
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11751 ALTA VISTA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6442
Mailing Address - Country:US
Mailing Address - Phone:817-562-1006
Mailing Address - Fax:817-562-1009
Practice Address - Street 1:11751 ALTA VISTA RD STE 201
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6442
Practice Address - Country:US
Practice Address - Phone:817-562-1006
Practice Address - Fax:817-562-1009
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111997225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3559510Medicaid
TX111997OtherTEXAS OCCUPATIONAL THERAPY LICENSE