Active NPI
Marlene Bolton
- Physical Therapist
- Flatonia, TX
National Provider Identifier
1295123149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1012367
- Practice address
- 624 N Converse St
Flatonia, TX 78941-2535 - Phone
- (361) 865-3469
- Fax
- (361) 865-3469
- NPI assigned
- Dec 30, 2014
- Last updated
- Dec 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1012367 | TX | Primary |
Addresses
Primary practice location
624 N Converse St
Flatonia, TX 78941-2535
Mailing address
PO Box 513
La Grange, TX 78945-0513
Phone (361) 865-3469
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 |
|---|---|---|---|
| 1012367 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1295123149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 513",
"city": "LA GRANGE",
"state": "TX",
"postal_code": "789450513",
"telephone_number": "361-865-3469",
"fax_number": "361-865-3469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 N CONVERSE ST",
"city": "FLATONIA",
"state": "TX",
"postal_code": "789412535",
"telephone_number": "361-865-3469",
"fax_number": "361-865-3469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "MARLENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-30",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1012367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flatonia, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.