Organization Active NPI

Optimum Physical Therapy and Sports Rehab PLLC

  • Physical Therapist
  • Missouri City, TX
National Provider Identifier
1346818606
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OPTIMUM PHYSICAL THERAPY AND SPORTS REHAB PLLC
Practice address
5819 Highway 6 Ste 100a
Missouri City, TX 77459-4052
Phone
(713) 244-8688
Fax
(713) 263-3235
NPI assigned
Jun 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Mrs. Premila Martin, PTNPI 1154531739
Title
Director / Owner
Phone
(281) 969-8922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X
Physical Rehabilitation Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0019X

Addresses

Primary practice location

5819 Highway 6 Ste 100a
Missouri City, TX 77459-4052

Mailing address

5819 Highway 6 Ste 100a
Missouri City, TX 77459-4052
Phone (281) 969-8922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220113000254 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0840698759 Receives reassigned benefits from 3 practitioners
Practice locations: Missouri City, TX

National Provider Directory

National Provider Directory

Locations

5819 Highway 6
Ste 100A
Missouri City, TX 77459
Phone (281) 969-8922

5819 Highway 6
Ste 100
Missouri City, TX 77459
Phone (713) 244-8688

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1346818606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 HIGHWAY 6 STE 100A",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594052",
            "telephone_number": "281-969-8922",
            "fax_number": "281-969-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 HIGHWAY 6 STE 100A",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594052",
            "telephone_number": "713-244-8688",
            "fax_number": "713-263-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PHYSICAL THERAPY AND SPORTS REHAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2023-03-27",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "PREMILA",
        "authorized_official_title_or_position": "DIRECTOR / OWNER",
        "authorized_official_telephone_number": "281-969-8922",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.