Individual provider Active NPI

Janette Mejia, P.T.A.

  • Physical Therapy Assistant
  • Bryan, TX
National Provider Identifier
1639587124
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2103935 Issued in TX
Practice address
1318 Memorial Dr
Bryan, TX 77802-5215
Phone
(979) 776-2872
Fax
(979) 776-1456
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2103935 TX Primary

Addresses

Primary practice location

1318 Memorial Dr
Bryan, TX 77802-5215

Mailing address

1318 Memorial Dr
Bryan, TX 77802-5215
Phone (979) 776-2872

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
2103935TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1639587124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215",
            "telephone_number": "979-776-2872",
            "fax_number": "979-776-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215",
            "telephone_number": "979-776-2872",
            "fax_number": "979-776-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "JANETTE",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2103935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.