Samuel Carmona, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2082776 Issued in TX

Practice address

12709 Toepperwein Rd Ste 101
Live Oak, TX 78233-3259

Phone

(210) 477-5151

NPI assigned

Nov 3, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649782350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD STE 101",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD STE 101",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333259",
            "telephone_number": "210-477-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18707 Hardy Oak Blvd Ste 415",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782584841",
            "country_code": "US",
            "telephone_number": "210-477-5151 x108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8715 Village Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782175425",
            "country_code": "US",
            "telephone_number": "210-477-5151 x108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "SAMUEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2082776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.