Maricel Secapure Chua

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1211243 Issued in TX

Practice address

500 Valle Vista Dr
Athens, TX 75751-2760

Phone

(903) 677-3434

NPI assigned

Aug 21, 2018

Sex

Female

Sole proprietor

No

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, last updated by the provider on Aug 21, 2018.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1407336142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 JEFFERY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034830",
            "telephone_number": "843-407-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VALLE VISTA DR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757512760",
            "telephone_number": "903-677-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "MARICEL",
        "middle_name": "SECAPURE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1211243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charter Healthcare of Dallas, LLC
• Nathan Robert Chatriand
• Children'S Crisis Prevention Network, Inc.
• Jonathan L Chrest, MD
• Christopher R. Johnson, M.D., P.a.
• Sean R Clair, CRNA
• Alicia Danielle Cleaver, D.O.
• Mark A Clemons, PSY.D.
• Matthew Bennett Coggins, PHARMD
• Coker and Qualls, PA

• All providers in Athens, TX
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.