Myranda Devyn Valenzuela, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2164918 Issued in TX

Practice address

1800 Broadway St Apt 2015
San Antonio, TX 78215-1298

Phone

(210) 238-6413

NPI assigned

Apr 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1073256079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BROADWAY ST APT 2105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151345",
            "telephone_number": "210-238-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BROADWAY ST APT 2015",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151298",
            "telephone_number": "210-238-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "MYRANDA",
        "middle_name": "DEVYN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2164918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "HealthTrust",
            "affiliation": "N",
            "address_1": "1800 Broadway St Apt 2015",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782151298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gumercindo Valenzuela Jr.
• Jaime Alejandro Valenzuela
• Jessica Jazmin Valenzuela
• Laura Monic Valenzuela, PTA
• Michaela Ann Valenzuela
• Roberto Valenzuela
• Jeannette Castilleja Valera, NURSE PRACTITIONER
• Victoria McCord Valerga
• Larissa Valeriano, MS, LPC ASSOCIATE
• Valerie Baldwin Thomas, LLS

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, 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 Apr 18, 2022; 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.