Engelbert Dizon De Vera, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1125821 Issued in TX

Practice address

5113 Spring Brook Dr
Corpus Christi, TX 78413-5629

Phone

(361) 248-2004

Fax

(888) 499-1749

NPI assigned

Jan 8, 2020

Last updated

Jan 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optimus Rehab LLC

  • Physical Therapist
  • Corpus Christi, TX
  • NPI 1891335741
  Authorized official Same address or phone

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1407496359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61160",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784661160",
            "telephone_number": "361-884-2904",
            "fax_number": "361-884-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 SPRING BROOK DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135629",
            "telephone_number": "361-248-2004",
            "fax_number": "888-499-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "ENGELBERT",
        "middle_name": "DIZON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1125821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS",
            "identifier": "1125821",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Del Rosario De Los Santos, MD
• Melinda De Los Santos, P.T.
• Nedia Nicole De Lua-Ruiz, PMHNP-BC
• Rachelle De Mesa
• Hector De Pena III
• Marita Santiago De Vera, PT
• Orlando Clauren De Vera, PT
• Maria Dean, SLP
• Kayla Danford Deanda, LMT
• David Deaton

• Physical Therapist in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.