Jillian Mahan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1188449 Issued in TX

Practice address

1005 NE Big Bend TRL Unit 7
Glen Rose, TX 76043-4943

Phone

(254) 897-3176

NPI assigned

Mar 14, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1215478938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 COUNTY ROAD 412",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760436000",
            "telephone_number": "832-247-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 NE BIG BEND TRL UNIT 7",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434943",
            "telephone_number": "254-897-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "JILLIAN",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1188449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tiffany Oates, FNP
• Hernan Patino, M.D.

• Physical Therapist in Glen Rose, TX
• Providers in Glen Rose, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.