Individual provider Active NPI

Oyenike O. Fasanya, PT

  • Pediatric Physical Therapist
  • Garland, TX
National Provider Identifier
1235453697
Registry record updated Mar 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1191110 Issued in TX
Practice address
2625 Anita Drive
Garland, TX 75041
Phone
(972) 926-2671
Fax
(972) 926-2679
NPI assigned
Mar 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 1191110 TX Primary

Addresses

Primary practice location

2625 Anita Drive
Garland, TX 75041

Mailing address

2625 Anita Drive
Garland, TX 75041
Phone (972) 926-2671

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
1191110TXMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elim Healthcare Services, P.T.P.C. Pediatrics Past Accepting new patients
Parents in Partnership Eci Program Past 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": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1235453697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 ANITA DRIVE",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75041",
            "telephone_number": "972-926-2671",
            "fax_number": "972-926-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 ANITA DRIVE",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75041",
            "telephone_number": "972-926-2671",
            "fax_number": "972-926-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANYA",
        "first_name": "OYENIKE",
        "middle_name": "O.",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1191110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.