Lenita D Broussard, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2157497 Issued in TX

Practice address

1620 Magnolia St
Liberty, TX 77575-3546

Phone

(936) 336-8844

NPI assigned

Sep 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1346856564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 MONTGOMERY RD APT 14",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405903",
            "telephone_number": "979-383-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 MAGNOLIA ST",
            "city": "LIBERTY",
            "state": "TX",
            "postal_code": "775753546",
            "telephone_number": "936-336-8844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 Montgomery Rd Apt 14",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "TX",
            "postal_code": "773405903",
            "country_code": "US",
            "telephone_number": "979-383-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "LENITA",
        "middle_name": "D",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2157497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bassam a. Hamid M.D.,P.a. Urgent Care/Primarycare
• Holly Benson, NP-C
• Stephen L Beyer
• Steven Wayne Branham, RN, ACNP
• Brookshire Brothers Inc
• Arthur Reese Brown, M.D.
• Bryan Rehabiltation Services, Inc.
• Joe E Callaway
• Don Shannon Callens, MD
• Kendra Caswell, MS CCC-SLP

• Physical Therapy Assistant in Liberty, TX
• Providers in Liberty, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.