Texas Physical Therapy Services of Tyler, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TEXAS PHYSICAL THERAPY SERVICES OF TYLER, LLC

Doing business as

Texas Physical Therapy Services of Tyler

Practice address

2498 Three Lakes Parkway
Tyler, TX 75703

Phone

(903) 707-1640

Fax

(903) 405-1625

NPI assigned

May 28, 2024

Last updated

May 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joshua L. Proffitt

Title

President

Phone

(337) 233-1307

Specialties & licenses 3

Addresses

Other names 1

• Texas Physical Therapy Services of Tyler Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shonda Juarez

  • Physical Therapist
  • Tyler, TX
  • NPI 1043791908
  Medicare reassignment Care Compare group NPD
• Phillip Anthony McKee Jr., P.T.

  • Physical Therapist
  • Haughton, LA
  • NPI 1437178373

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1285474387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2498 THREE LAKES PARKWAY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-707-1640",
            "fax_number": "903-405-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS PHYSICAL THERAPY SERVICES OF TYLER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Physical Therapy Services of Tyler",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Texas Arthritis and Rheumatology
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• Texas Oncology, P.a.
• Texas Palliative Care
• Texas Spine and Joint Hospital, LLC (Baylor Scott & White TX Spine & Joint Hosp Urgent Care)
• Texas Spine and Joint Hospital, LLC (Baylor Scott & White TX Spine & Joint Hos Imaging Ctr)
• Hannah Thacker, MOT, OTR/L
• Sivagowri Tharmendira, MD
• The Bradley Clinic of Texas, PLLC

• Physical Therapist in Tyler, TX
• Providers in Tyler, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.