Active NPI
Lewis Thomas Petmecky, L.A.T.
- Athletic Trainer
- Spring Branch, TX
National Provider Identifier
1679921506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0808
- Practice address
- 14001 Highway 46 W
Spring Branch, TX 78070-7053 - Phone
- (210) 559-0182
- NPI assigned
- Jun 1, 2016
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0808 | TX | Primary |
Addresses
Primary practice location
14001 Highway 46 W
Spring Branch, TX 78070-7053
Mailing address
14001 Highway 46 W
Spring Branch, TX 78070-7053
Phone (210) 559-0182
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 |
|---|---|---|---|
| AT0808 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464739200000",
"number": "1679921506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14001 HIGHWAY 46 W",
"city": "SPRING BRANCH",
"state": "TX",
"postal_code": "780707053",
"telephone_number": "210-559-0182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14001 HIGHWAY 46 W",
"city": "SPRING BRANCH",
"state": "TX",
"postal_code": "780707053",
"telephone_number": "210-559-0182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETMECKY",
"first_name": "LEWIS",
"middle_name": "THOMAS",
"credential": "L.A.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-01",
"last_updated": "2016-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT0808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Branch, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.