Individual provider Active NPI

Matthew Wiseman, DPT,PT

  • Physical Therapist
  • Fulshear, TX
National Provider Identifier
1184929168
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1394746 Issued in TX
Practice address
29615 FM 1093 Rd Ste 2
Fulshear, TX 77441-3926
Phone
(281) 533-0507
Fax
(281) 533-0521
NPI assigned
Jan 21, 2011
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-3831 ID
Physical Therapist 225100000X 10358145-2401 UT
Physical Therapist 225100000X 1394746 TX Primary

Addresses

Primary practice location

29615 FM 1093 Rd Ste 2
Fulshear, TX 77441-3926

Mailing address

29615 FM 1093 Rd Ste 2
Fulshear, TX 77441-3926
Phone (281) 533-0507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219003230 TX Practitioner - Physical Therapist in Private Practice 2264952373 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Luna Care Physical Therapy LLCGroup PAC ID 0648692723, 271 clinicians

Practice addresses (Care Compare)

180 State St
Suite 225
Southlake, TX 76092-7632
Phone (866) 525-3175

29615 FM 1093 Rd
Suite 2
Fulshear, TX 77441-3926
Phone (281) 533-0507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-3831IDMDPhysical Therapist
1394746TXMDPhysical Therapist
10358145-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DMXQ, LLC Physical Therapist CurrentSince Dec 19, 2024 Accepting new patients
Blue Lagune Therapy, Inc Physical Therapist CurrentSince Dec 19, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Dec 30, 2025 Accepting new patients
Star Therapy Centers Limited Partnership Physical Therapist CurrentSince Mar 23, 2026 Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 30, 2025 Accepting new patients
Baylor College of Medicine CurrentSince Dec 30, 2025 Accepting new patients
Ellis Physical Therapy P a Physical Therapist PastSince Apr 1, 2013 Accepting new patients
Ellis Physical Therapy and Associates LLC Physical Therapist PastSince Jan 26, 2020 Accepting new patients
Star Therapy Centers Limited Partnership Physical Therapist PastSince Mar 23, 2026 Accepting new patients

Locations

29615 FM 1093 Rd
Ste 2
Fulshear, TX 77441
Phone (281) 533-0507

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

1115 Avenue D
Katy, TX 77493
Phone (281) 712-4835

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1184929168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29615 FM 1093 RD STE 2",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774413926",
            "telephone_number": "281-533-0507",
            "fax_number": "281-533-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29615 FM 1093 RD STE 2",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774413926",
            "telephone_number": "281-533-0507",
            "fax_number": "281-533-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "MATTHEW",
        "credential": "DPT,PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-21",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3831",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "10358145-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1394746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulshear, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.