Individual provider Active NPI

Eduardo Javier Esparza

  • Physical Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1417437278
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2040517 Issued in TX
Practice address
4949 Ravenswood Dr
San Antonio, TX 78227-4320
Phone
(956) 334-5470
NPI assigned
Aug 20, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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 2040517 TX Primary

Addresses

Primary practice location

4949 Ravenswood Dr
San Antonio, TX 78227-4320

Mailing address

12701 West Ave Apt 418
San Antonio, TX 78216-1853

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
2040517TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1417437278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 WEST AVE APT 418",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782161853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 RAVENSWOOD DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782274320",
            "telephone_number": "956-334-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPARZA",
        "first_name": "EDUARDO",
        "middle_name": "JAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2040517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.