Active NPI
Jenna Tan
- Physical Therapist
- Houston, TX
National Provider Identifier
1073127171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1329407
- Practice address
- 4100 N Sam Houston Pkwy W Ste 240
Houston, TX 77086-1466 - Phone
- (832) 968-7155
- Fax
- (713) 383-9795
- NPI assigned
- Sep 4, 2020
- Last updated
- Sep 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225100000X | 1329407 | TX | Primary |
Addresses
Primary practice location
4100 N Sam Houston Pkwy W Ste 240
Houston, TX 77086-1466
Mailing address
4100 N Sam Houston Pkwy W Ste 240
Houston, TX 77086-1466
Phone (832) 968-7155
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 |
|---|---|---|---|
| 1329407 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TCG Home Health LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599177600000",
"number": "1073127171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 N SAM HOUSTON PKWY W STE 240",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770861466",
"telephone_number": "832-968-7155",
"fax_number": "713-383-9795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 N SAM HOUSTON PKWY W STE 240",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770861466",
"telephone_number": "832-968-7155",
"fax_number": "713-383-9795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "JENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-04",
"last_updated": "2020-09-04",
"certification_date": "2020-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1329407",
"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 4, 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.