Individual provider Active NPI

Vincent Marcian Gacilos II, PTA

  • Physical Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1437674785
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2126775 Issued in TX
Practice address
5423 Hamilton Wolfe Rd
San Antonio, TX 78229-4344
Phone
(210) 694-9494
NPI assigned
Aug 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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 2126775 TX Primary

Addresses

Primary practice location

5423 Hamilton Wolfe Rd
San Antonio, TX 78229-4344

Mailing address

14811 Huebner Rd
San Antonio, TX 78231-1741

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
2126775TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1437674785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14811 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5423 HAMILTON WOLFE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294344",
            "telephone_number": "210-694-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GACILOS",
        "first_name": "VINCENT",
        "middle_name": "MARCIAN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2126775",
            "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 8, 2017; 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.