Active NPI
Lisa Despain
- Physical Therapist
- Round Rock, TX
National Provider Identifier
1174909337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1261436
- Practice address
- 2000 S Ih 35
Suite L-1
Round Rock, TX 78681-6900 - Phone
- (512) 238-6200
- Fax
- (512) 238-6700
- NPI assigned
- Aug 10, 2015
- Last updated
- Aug 10, 2015
- Sex
- Female
- 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 | 1261436 | TX | Primary |
Addresses
Primary practice location
2000 S Ih 35
Suite L-1
Round Rock, TX 78681-6900
Mailing address
1704 Fawn CV
Round Rock, TX 78681-1705
Phone (512) 680-4862
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1261436 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1174909337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 FAWN CV",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786811705",
"telephone_number": "512-680-4862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 S IH 35",
"address_2": "SUITE L-1",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786816900",
"telephone_number": "512-238-6200",
"fax_number": "512-238-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESPAIN",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1261436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.