Individual provider Active NPI

Angela Yvonne Eusery, PTA

  • Physical Therapy Assistant
  • Dallas, TX
National Provider Identifier
1558501338
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2030575 Issued in TX
Practice address
9441 LBJ Freeway #101
Supplemental Health Care
Dallas, TX 75243
Phone
(866) 575-9820
NPI assigned
Mar 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2030575 TX Primary
Massage Therapist 225700000X MT029946 TX

Addresses

Primary practice location

9441 LBJ Freeway #101
Supplemental Health Care
Dallas, TX 75243

Mailing address

2351 Shirebrook CT
Grand Prairie, TX 75052-7815
Phone (972) 606-4988

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

LicenseStateTypeSpecialty
2030575TXMDPhysical Therapy Assistant
MT029946TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1558501338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 SHIREBROOK CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750527815",
            "telephone_number": "972-606-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 LBJ FREEWAY #101",
            "address_2": "SUPPLEMENTAL HEALTH CARE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "866-575-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSERY",
        "first_name": "ANGELA",
        "middle_name": "YVONNE",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2030575",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT029946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.