Stayce Wade Phillips, PTA
Individual provider Active NPI Physical Therapy Assistant · Pittsburg, TX
NPI 1245866508 · NPPES record last updated Mar 19, 2020
Key facts
- NPI
- 1245866508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2056082 (TX)
- Practice address
- 2801 Hwy 271 N.
Pittsburg, TX 75686 - Phone
- (903) 946-5466
- Fax
- (903) 946-5461
- NPI assigned
- Mar 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2056082 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2056082 | TX | Yes |
Addresses
Primary practice location
2801 Hwy 271 N.
Pittsburg, TX 75686
Mailing address
2801 Hwy 271 N.
Pittsburg, TX 75686
Phone (903) 946-5466
Other providers in Pittsburg, TX
- Jamie Nixon
- Ortholonestar, PLLC
- Parker Drug Inc
- Peachtree Diagnostics PLLC
- Robyn Lynn Perry
- Leonard Pingatore
- Curtis Oscar Pitton
- Pittsburg Hospital LLC
- Pittsburg Hospital LLC
- Pittsburg Hospital LLC
All providers in Pittsburg, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.