Walter McClung, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2132376 Issued in TX

Practice address

2990 Laurel St
Beaumont, TX 77702-2104

Phone

(409) 861-1009

Fax

(409) 861-4009

NPI assigned

Oct 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeast Texas Hematology and Oncology Center, PA

  • Specialist
  • Port Arthur, TX
  • NPI 1598749491
  NPD (past)
• Triangle Therapeutics

  • Specialist
  • Port Arthur, TX
  • NPI 1619995651
  NPD (past)

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053821595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5957 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776426204",
            "telephone_number": "409-982-8878",
            "fax_number": "409-982-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 LAUREL ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777022104",
            "telephone_number": "409-861-1009",
            "fax_number": "409-861-4009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5957 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Port Arthur",
            "state": "TX",
            "postal_code": "776426204",
            "country_code": "US",
            "telephone_number": "409-982-8878",
            "fax_number": "409-982-5119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLUNG",
        "first_name": "WALTER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2132376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P. McCarble, ATP
• Dana McClain Miller, MSN, APRN, FNP-C
• Summer McClain, FNP-C
• Kathleen McClelland, R.PH.
• Yaheiya Sharondele McClendon, COTA / L
• Julie McClure, RN, MSN, CFNP
• Robert G. McConnell, M.D.
• Michael David McCord, M.D.
• Mary Margaret McCormick
• Paul W. McCormick, M.D.

• Physical Therapy Assistant in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.