Active NPI
Victoria Joy Samuelson, PTA
- Physical Therapy Assistant
- Allen, TX
National Provider Identifier
1508344334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2140302
- Practice address
- 915 W Exchange Pkwy Ste 100
Allen, TX 75013-7018 - Phone
- (214) 547-1571
- NPI assigned
- Aug 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 2140302 | TX | Primary |
Addresses
Primary practice location
915 W Exchange Pkwy Ste 100
Allen, TX 75013-7018
Mailing address
553 Rocky Point Rd
Conway, AR 72032-9726
Phone (501) 733-9629
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2140302 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1508344334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "553 ROCKY POINT RD",
"city": "CONWAY",
"state": "AR",
"postal_code": "720329726",
"telephone_number": "501-733-9629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 W EXCHANGE PKWY STE 100",
"city": "ALLEN",
"state": "TX",
"postal_code": "750137018",
"telephone_number": "214-547-1571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELSON",
"first_name": "VICTORIA",
"middle_name": "JOY",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-02",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2140302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.