Active NPI
Terry Matthew Clay
- Physical Therapist
- Gonzales, TX
National Provider Identifier
1649744301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1131514
- Practice address
- 1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311 - Phone
- (830) 672-7581
- Fax
- (830) 672-8481
- NPI assigned
- Jan 16, 2019
- Last updated
- Jan 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 1131514 | TX | Primary |
Addresses
Primary practice location
1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Mailing address
311 N Hamilton St
Gonzales, TX 78629-4005
Phone (830) 263-2750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1131514 | Other | TX | PT LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1131514 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1649744301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 N HAMILTON ST",
"city": "GONZALES",
"state": "TX",
"postal_code": "786294005",
"telephone_number": "830-263-2750",
"fax_number": "830-672-8481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 N SARAH DEWITT DR",
"city": "GONZALES",
"state": "TX",
"postal_code": "786293311",
"telephone_number": "830-672-7581",
"fax_number": "830-672-8481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "TERRY",
"middle_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1131514",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "1131514",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gonzales, TX
- Dorothy J. Cantu, RDA
- Paul Daniel Cardenas, PHARM.D
- Cartwheel Gonzales Real Estate Partnership LTD (Cartwheel Lodge of Gonzales)
- Venessa Lynn Castillo, CPHT
- Children's Dentistry of Kyle (Children's Dentistry of Gonzales)
- Charlene Ann Cockcroft
- William Frnak Cole, M.D.
- Community Health Centers of South Central Texas, Inc.
- Community Health Centers of South Central Texas, Inc. (Women's Health and WIC Center)
- Christina M Cordova, LVN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.