Active NPI
Jaime Eduardo Olmos
- Physical Therapy Assistant
- Dumas, TX
National Provider Identifier
1366935462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2137397
- Practice address
- 224 E 2ND St
Dumas, TX 79029-3808 - Phone
- (806) 934-6018
- NPI assigned
- Jun 13, 2018
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 2137397 | TX | Primary |
Addresses
Primary practice location
224 E 2ND St
Dumas, TX 79029-3808
Mailing address
708 Durrett Ave
Dumas, TX 79029-4521
Phone (806) 930-6540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2137397 | Other | TX | TX PTA LICENSE |
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 |
|---|---|---|---|
| 2137397 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1366935462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 DURRETT AVE",
"city": "DUMAS",
"state": "TX",
"postal_code": "790294521",
"telephone_number": "806-930-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 E 2ND ST",
"city": "DUMAS",
"state": "TX",
"postal_code": "790293808",
"telephone_number": "806-934-6018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLMOS",
"first_name": "JAIME",
"middle_name": "EDUARDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-13",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2137397",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX PTA LICENSE",
"identifier": "2137397",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dumas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.