Active NPI
Angela Elaine Holder, P.T. PHYSICAL THERAP
- Physical Therapist
- Lawton, OK
National Provider Identifier
1053405639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2529
- Practice address
- 1618 NE 31St St
Lawton, OK 73507-3432 - Phone
- (405) 747-4358
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2529 | OK | |
| Physical Therapist | 225100000X | 2529 | OK | Primary |
Addresses
Primary practice location
1618 NE 31St St
Lawton, OK 73507-3432
Mailing address
Box 54
Gould, OK 73544
Phone (405) 747-4358
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200038480B | Medicaid | OK | |
| 200038480A | Medicaid | OK |
Other names 1
- Angela Elaine Valdez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2529 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1053405639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 54",
"city": "GOULD",
"state": "OK",
"postal_code": "73544",
"telephone_number": "405-747-4358",
"fax_number": "580-676-3951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1618 NE 31ST ST",
"city": "LAWTON",
"state": "OK",
"postal_code": "735073432",
"telephone_number": "405-747-4358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "ANGELA",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "P.T. PHYSICAL THERAP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OK",
"license": "2529",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "2529",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200038480B",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200038480A",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "VALDEZ",
"middle_name": "ELAINE",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.