Individual provider Active NPI

Gabriel Valdez

  • Physical Therapy Assistant
  • Carrollton, TX
National Provider Identifier
1669148664
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
4541 N Josey LN Ste 130
Carrollton, TX 75010-4662
Phone
(469) 212-8888
NPI assigned
Aug 19, 2021
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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 Primary

Addresses

Primary practice location

4541 N Josey LN Ste 130
Carrollton, TX 75010-4662

Mailing address

4541 N Josey LN Ste 130
Carrollton, TX 75010-4662
Phone (469) 212-8888

Other identifiers 1

IdentifierTypeStateIssuer
34415932OtherTXDRIVERS 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

Practice roles

OrganizationSpecialtyStatusNew patients
Surecure LLC CurrentSince Aug 28, 2021 Accepting new patients

Locations

4541 N Josey Ln
Ste 130
Carrollton, TX 75010
Phone (469) 212-8888

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1669148664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 N JOSEY LN STE 130",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104662",
            "telephone_number": "469-212-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 N JOSEY LN STE 130",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104662",
            "telephone_number": "469-212-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "GABRIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "34415932",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.