Justin Michael Anderson, PT
Individual provider Active NPI Physical Therapist · League City, TX
NPI 1124793740 · NPPES record last updated Aug 16, 2021
Key facts
- NPI
- 1124793740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1349629 (TX)
- Practice address
- 2240 Gulf Fwy S
League City, TX 77573-5143 - Phone
- (409) 772-1011
- NPI assigned
- Aug 16, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1349629 | TX | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1349629 | TX | Yes |
Addresses
Primary practice location
2240 Gulf Fwy S
League City, TX 77573-5143
Mailing address
1408 Tanner Woods LN
Friendswood, TX 77546-1433
Phone (970) 227-2922
Other providers in League City, TX
- Angelique Rose Andaverde
- Anderson Guderian Medical Association
- Aimee Roulaine Anderson
- Jenelle Marie Anderson
- Jennifer Dittrich Anderson
- Gretchen L Andrew
- Regina M Andrews-Duarte
- Jimmie Gail Andrews-Marsh
- Shunta Monique Antwi
- Stephen Antwi
All providers in League City, TX · Physical Therapist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.