Active NPI
Devaughn Cornell Vinson, PTA
- Physical Therapy Assistant
- Houston, TX
National Provider Identifier
1063995082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2042778
- Practice address
- 7499 Stanwick Dr
Houston, TX 77087-6119 - Phone
- (713) 644-8048
- Fax
- (713) 649-8826
- NPI assigned
- Sep 14, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2042778 | TX | Primary |
Addresses
Primary practice location
7499 Stanwick Dr
Houston, TX 77087-6119
Mailing address
2711 Newbury CT
Pearland, TX 77584-7090
Phone (210) 386-6993
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 |
|---|---|---|---|
| 2042778 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536883200000",
"number": "1063995082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2711 NEWBURY CT",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775847090",
"telephone_number": "210-386-6993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7499 STANWICK DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770876119",
"telephone_number": "713-644-8048",
"fax_number": "713-649-8826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINSON",
"first_name": "DEVAUGHN",
"middle_name": "CORNELL",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-14",
"last_updated": "2018-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2042778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.