Juan Jose Fabian, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2049040 Issued in TX

Practice address

1638 VZ 1803
Grand Saline, TX 75140-7514

Phone

(903) 962-7595

NPI assigned

Aug 9, 2018

Last updated

Aug 9, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1134608326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 VZ CR 1803",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "75140",
            "telephone_number": "903-275-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 VZ 1803",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751407514",
            "telephone_number": "903-962-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "JUAN",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2049040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Dheere, MA-CCC-SLP
• Dierksen Hospice LLC
• East Texas Medical Center Quitman (Etmc First Physicians Clinic Grand Saline)
• Ekklesia Healthcare, L.L.C. (Azalea Trail Nursing and Rehabilitation Center)
• Sharon Evans, MSLP
• Family Medicine Rural Health Clinic
• Katelin Nicole Free
• Grand Saline I S D
• Michael Lee Green, RPH
• Greenhart

• Physical Therapy Assistant in Grand Saline, TX
• Providers in Grand Saline, 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 Aug 9, 2018; 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.