Lorelie Anne Consulta Pena

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1281351 Issued in TX

Practice address

4001 US Highway 59 N
Livingston, TX 77351-4663

Phone

(813) 713-4844

NPI assigned

Mar 29, 2022

Sex

Female

Sole proprietor

Yes

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1376283358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TREY ST",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773512276",
            "telephone_number": "813-713-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 US HIGHWAY 59 N",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514663",
            "telephone_number": "813-713-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "LORELIE ANNE",
        "middle_name": "CONSULTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1281351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Pagone - Wilson, M.S., BCBA
• Reshmibhat Parameswaranunni
• Avikumar Patel
• Jasmin Clara Pathiyil, DMD
• Catherine Lawless Patschke, MS, RD, LD
• Edward Harold Pendleton, MA, LPC, LCDC
• Raoul Perez, MD
• Brooke Petty
• Hao Mai Ngoc Pham, DDS
• Vien Thuy Pham, MD

• Physical Therapy Clinic/Center in Livingston, TX
• Providers in Livingston, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.