Active NPI
Jessica Mae Beausoleil, DPT, PT
- Physical Therapist
- Garland, TX
National Provider Identifier
1508413790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1320285
- Practice address
- 930 W Centerville Rd Ste C
Garland, TX 75041-5854 - Phone
- (792) 303-7021
- NPI assigned
- Aug 22, 2019
- Last updated
- Aug 22, 2019
- 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 Therapist | 225100000X | 1320285 | TX | Primary |
Addresses
Primary practice location
930 W Centerville Rd Ste C
Garland, TX 75041-5854
Mailing address
2604 Kimberly LN
Plano, TX 75075-6687
Phone (860) 428-4298
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 |
|---|---|---|---|
| 1320285 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1508413790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2604 KIMBERLY LN",
"city": "PLANO",
"state": "TX",
"postal_code": "750756687",
"telephone_number": "860-428-4298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W CENTERVILLE RD STE C",
"city": "GARLAND",
"state": "TX",
"postal_code": "750415854",
"telephone_number": "792-303-7021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUSOLEIL",
"first_name": "JESSICA",
"middle_name": "MAE",
"name_prefix": "Dr.",
"credential": "DPT, PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-22",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1320285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.