Individual provider Active NPI

Pablo Adan Puga Jr., PT, DPT

  • Physical Therapist
  • Greenville, TX
National Provider Identifier
1184473241
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1392110 Issued in TX
Practice address
5101 Wellington St Ste B
Greenville, TX 75402-6012
Phone
(903) 408-7760
NPI assigned
May 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 1392110 TX
Physical Therapist 225100000X 1392110 TX Primary

Addresses

Primary practice location

5101 Wellington St Ste B
Greenville, TX 75402-6012

Mailing address

5101 Wellington St Ste B
Greenville, TX 75402-6012
Phone (903) 408-7760

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

LicenseStateTypeSpecialty
1392110TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hunt Regional Medical Partners Specialists PastSince May 19, 2024 Accepting new patients
Hunt Memorial Hospital District PastSince May 19, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1184473241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 WELLINGTON ST STE B",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026012",
            "telephone_number": "903-408-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 WELLINGTON ST STE B",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026012",
            "telephone_number": "903-408-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGA",
        "first_name": "PABLO",
        "middle_name": "ADAN",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": "1392110",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1392110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.