Active NPI
Eddie Teague, P.T.
- Physical Therapist
- Port Lavaca, TX
National Provider Identifier
1538577903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1-6859-1
- Practice address
- 1300 N Virginia St
Port Lavaca, TX 77979-2509 - Phone
- (361) 551-2513
- Fax
- (361) 551-2528
- NPI assigned
- Jul 29, 2014
- Sex
- Male
- 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 | 1-6859-1 | TX | Primary |
Addresses
Primary practice location
1300 N Virginia St
Port Lavaca, TX 77979-2509
Mailing address
1300 N Virginia St
Port Lavaca, TX 77979-2509
Phone (361) 551-2513
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 |
|---|---|---|---|
| 1-6859-1 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1538577903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N VIRGINIA ST",
"city": "PORT LAVACA",
"state": "TX",
"postal_code": "779792509",
"telephone_number": "361-551-2513",
"fax_number": "361-551-2528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N VIRGINIA ST",
"city": "PORT LAVACA",
"state": "TX",
"postal_code": "779792509",
"telephone_number": "361-551-2513",
"fax_number": "361-551-2528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEAGUE",
"first_name": "EDDIE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-29",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1-6859-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Lavaca, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.