Active NPI
Elisa F Cruz, PT
- Physical Therapist
- Texarkana, TX
National Provider Identifier
1508923905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1080893
- Practice address
- 1002 Texas Blvd Ste 406
Attention PT Dept
Texarkana, TX 75501-5113 - Phone
- (903) 794-4196
- Fax
- (903) 794-4198
- NPI assigned
- Jan 3, 2007
- 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 Therapist | 225100000X | 1080893 | TX | Primary |
Addresses
Primary practice location
1002 Texas Blvd Ste 406
Attention PT Dept
Texarkana, TX 75501-5113
Mailing address
1002 Texas Blvd Ste 406
Attention PT Dept
Texarkana, TX 75501-5113
Phone (903) 794-4196
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8T6171 | Other | TX | BCBS OF TEXAS |
| 83869 | Other | AR | BCBS ARKANSAS PROV # |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1080893 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508923905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 TEXAS BLVD STE 406",
"address_2": "ATTENTION PT DEPT",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755015113",
"telephone_number": "903-794-4196",
"fax_number": "903-794-4198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 TEXAS BLVD STE 406",
"address_2": "ATTENTION PT DEPT",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755015113",
"telephone_number": "903-794-4196",
"fax_number": "903-794-4198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "ELISA",
"middle_name": "F",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1080893",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "8T6171",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ARKANSAS PROV #",
"identifier": "83869",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, 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.