Leta Hollis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2024180 Issued in TX

Practice address

102 E Grand PLZ
Grand Saline, TX 75140-1932

Phone

(903) 962-7901

Fax

(903) 962-3082

NPI assigned

Sep 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Leta Grace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ellis Rehabilitation Services, Inc.

  • Rehabilitation Clinic/Center
  • Tyler, TX
  • NPI 1245240365
  NPD (past)

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205936929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VZCR 1519",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "75140",
            "telephone_number": "903-963-4108",
            "fax_number": "903-962-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E GRAND PLZ",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751401932",
            "telephone_number": "903-962-7901",
            "fax_number": "903-962-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "LETA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2024180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETA",
            "last_name": "GRACE",
            "prefix": "MRS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katelin Nicole Free
• Grand Saline I S D
• Michael Lee Green, RPH
• Greenhart
• GS Partners, LTD.
• Inayah Healthcare LLC
• Innate Hospital LLC
• Innate Hospital LLC
• Innate Medical Solutions PLLC
• Just Kids Home Health,Inc.

• 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 Jul 8, 2007; 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.