Individual provider Active NPI

Lord Joseph Virata Padilla, PT

  • Physical Medicine & Rehabilitation Physician
  • Dallas, TX
National Provider Identifier
1245630623
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
070.020514 Issued in TX
Practice address
1755 Wittington PL
Dallas, TX 75234-1927
Phone
(866) 221-5405
NPI assigned
Sep 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 070.020514 TX Primary

Addresses

Primary practice location

1755 Wittington PL
Dallas, TX 75234-1927

Mailing address

1755 Wittington PL Ste 175
Dallas, TX 75234-1927
Phone (866) 221-5405

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
070.020514TXMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1245630623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 WITTINGTON PL STE 175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752341927",
            "telephone_number": "866-221-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 WITTINGTON PL",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752341927",
            "telephone_number": "866-221-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "LORD JOSEPH",
        "middle_name": "VIRATA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "070.020514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.