NPIMap

Organization Active NPI

Performance Therapeutics - Eagle Pass, PLLC

  • Physical Therapist
  • Eagle Pass, TX
National Provider Identifier
1114266525
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
671310001 Issued in TX
Legal business name
PERFORMANCE THERAPEUTICS - EAGLE PASS, PLLC
Practice address
2483 2ND St
Suite B
Eagle Pass, TX 78852-4390
Phone
(830) 776-5181
NPI assigned
Feb 5, 2013
Last updated
Oct 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Omar PalominNPI 1184662926
Title
Ceo-Owner
Phone
(956) 687-4559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 671310001 TX Primary

Addresses

Primary practice location

2483 2ND St
Suite B
Eagle Pass, TX 78852-4390

Mailing address

2101 N 23Rd St
McAllen, TX 78501-6127
Phone (956) 687-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130516000218 TX Part B Supplier - Clinic/Group Practice 7810134541 Receives reassigned benefits from 17 practitioners
Practice locations: Eagle Pass, TX

National Provider Directory

National Provider Directory
Tax ID family
Performance Therapeutics - Eagle Pass PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1114266525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N 23RD ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016127",
            "telephone_number": "956-687-4559",
            "fax_number": "956-687-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 2ND ST",
            "address_2": "SUITE B",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524390",
            "telephone_number": "830-776-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE THERAPEUTICS - EAGLE PASS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-05",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "PALOMIN",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "CEO-OWNER",
        "authorized_official_telephone_number": "956-687-4559"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "671310001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.