Organization Active NPI

Fundamental Pediatric Therapy

  • Physical Therapist
  • Angleton, TX
National Provider Identifier
1508531633
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FUNDAMENTAL PEDIATRIC THERAPY
Practice address
938 E Myrtle St
Angleton, TX 77515-5816
Phone
(713) 384-3135
Fax
(832) 637-7499
NPI assigned
Aug 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Melissa Skillern, PT, DPT
Title
Owner/Physical Therapist
Phone
(713) 384-3135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

938 E Myrtle St
Angleton, TX 77515-5816

Mailing address

24 Signal Hill Dr
Manvel, TX 77578-3291
Phone (713) 384-3135

National Provider Directory

National Provider Directory

Locations

938 E Myrtle St
Angleton, TX 77515
Phone (713) 384-3135

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1508531633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SIGNAL HILL DR",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775783291",
            "telephone_number": "713-384-3135",
            "fax_number": "832-637-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 E MYRTLE ST",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775155816",
            "telephone_number": "713-384-3135",
            "fax_number": "832-637-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "SKILLERN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "713-384-3135",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angleton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.