Active NPI
Autumn Teesdale
- Physical Therapy Assistant
- Houston, TX
National Provider Identifier
1447360938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- Practice address
- 15311 Vantage Pkwy W
Ste 130
Houston, TX 77032-1954 - Phone
- (281) 442-6861
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Primary |
Addresses
Primary practice location
15311 Vantage Pkwy W
Ste 130
Houston, TX 77032-1954
Mailing address
2111 Trailing Vine Rd
Spring, TX 77373-6475
Phone (713) 398-4553
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2051797 | Other | TX | LICENSE# |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447360938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 TRAILING VINE RD",
"city": "SPRING",
"state": "TX",
"postal_code": "773736475",
"telephone_number": "713-398-4553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15311 VANTAGE PKWY W",
"address_2": "STE 130",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770321954",
"telephone_number": "281-442-6861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEESDALE",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "2051797",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.