Active NPI
Vicky Pavelka
- Physical Therapy Assistant
- Temple, TX
National Provider Identifier
1184034100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2023257
- Practice address
- 2010 SW H K Dodgen Loop
Suite 201
Temple, TX 76504-7062 - Phone
- (254) 774-9991
- Fax
- (254) 774-9980
- NPI assigned
- Apr 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 2023257 | TX | Primary |
Addresses
Primary practice location
2010 SW H K Dodgen Loop
Suite 201
Temple, TX 76504-7062
Mailing address
305 NE Loop 280
Business Tower 1, Suite 200
Hurst, TX 76053
Phone (817) 292-8787
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023257 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1184034100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 280",
"address_2": "BUSINESS TOWER 1, SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "76053",
"telephone_number": "817-292-8787",
"fax_number": "817-789-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 SW H K DODGEN LOOP",
"address_2": "SUITE 201",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765047062",
"telephone_number": "254-774-9991",
"fax_number": "254-774-9980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVELKA",
"first_name": "VICKY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-29",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2023257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.