Individual provider Active NPI

Vanessa Gay Carlile

  • Physical Therapy Assistant
  • Friendswood, TX
National Provider Identifier
1417219627
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2025690 Issued in TX
Practice address
510 Portage LN
Friendswood, TX 77546-3627
Phone
(832) 472-3008
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2025690 TX Primary

Addresses

Primary practice location

510 Portage LN
Friendswood, TX 77546-3627

Mailing address

510 Portage LN
Friendswood, TX 77546-3627
Phone (832) 472-3008

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

LicenseStateTypeSpecialty
2025690TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1417219627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 PORTAGE LN",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463627",
            "telephone_number": "832-472-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PORTAGE LN",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775463627",
            "telephone_number": "832-472-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLILE",
        "first_name": "VANESSA",
        "middle_name": "GAY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2025690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendswood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.