Active NPI
Oyenike O. Fasanya, PT
- Pediatric Physical Therapist
- Garland, TX
National Provider Identifier
1235453697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1191110
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1191110 | TX | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Case Management Agency
- Garland, TX
- NPI 1912121724
-
- Physical Therapy Clinic/Center
- Hollis, NY
- NPI 1730194549
Pediatrics
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.