Active NPI
Aeron Paul Salonga Punzalan
- Physical Therapist
- Abilene, TX
National Provider Identifier
1104208701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1254305
- Practice address
- 725 Medical Dr
Abilene, TX 79601-4524 - Phone
- (806) 228-3262
- NPI assigned
- Jun 19, 2015
- Last updated
- Apr 29, 2024
- 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 Therapist | 225100000X | 1254305 | TX | Primary |
Addresses
Primary practice location
725 Medical Dr
Abilene, TX 79601-4524
Mailing address
725 Medical Dr
Abilene, TX 79601-4524
Phone (806) 228-3262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1254305 | Other | TX | TX PT LINCENSE |
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 |
|---|---|---|---|
| 1254305 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1104208701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 MEDICAL DR",
"city": "ABILENE",
"state": "TX",
"postal_code": "796014524",
"telephone_number": "806-228-3262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 MEDICAL DR",
"city": "ABILENE",
"state": "TX",
"postal_code": "796014524",
"telephone_number": "806-228-3262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUNZALAN",
"first_name": "AERON PAUL",
"middle_name": "SALONGA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-19",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1254305",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX PT LINCENSE",
"identifier": "1254305",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.