Devic Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DEVIC PHYSICAL THERAPY

Practice address

7220 Vienta PT
Grand Prairie, TX 75054-0090

Phone

(817) 881-9677

NPI assigned

Jul 12, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Desiree NgwanahNPI 1891389300

Title

Owner

Phone

(817) 881-9677

Specialties & licenses 1

Addresses

Other names 1

• Devic Physical Therapy Former legal business name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Desiree Ngwanah

  • Physical Therapist
  • Flower Mound, TX
  • NPI 1891389300
  NPD Authorized official
• Victor Muna Ngwanah

  • Physical Therapy Assistant
  • Grand Prairie, TX
  • NPI 1629801444
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1013754357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 VIENTA PT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540090",
            "telephone_number": "817-881-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 VIENTA PT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540090",
            "telephone_number": "817-881-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVIC PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "NGWANAH",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-881-9677"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devic Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapist in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.