Justin Michael Anderson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1349629 Issued in TX

Practice address

2240 Gulf Fwy S
League City, TX 77573-5143

Phone

(409) 772-1011

NPI assigned

Aug 16, 2021

Last updated

Aug 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1124793740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 TANNER WOODS LN",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775461433",
            "telephone_number": "970-227-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GULF FWY S",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735143",
            "telephone_number": "409-772-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1349629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelique Rose Andaverde, MA
• Anderson Guderian Medical Association (Calder Urgent Care)
• Aimee Roulaine Anderson, LMFT
• Jenelle Marie Anderson, LPC
• Jennifer Dittrich Anderson, LMFT, LPC
• Gretchen L Andrew, PT
• Regina M Andrews-Duarte, MSW LCSW-S
• Jimmie Gail Andrews-Marsh, R.PH
• Shunta Monique Antwi, LPC
• Stephen Antwi, M.D.

• Physical Therapist in League City, TX
• Providers in League City, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.