Active NPI
Cruz Trevizo Jr.
- Physical Therapy Assistant
- Alpine, TX
National Provider Identifier
1699188466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4052871
- Practice address
- 710 E Holland Ave Ste 6
Alpine, TX 79830-5007 - Phone
- (432) 837-5918
- NPI assigned
- Jun 9, 2014
- Last updated
- Jun 9, 2014
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 4052871 | TX | Primary |
Addresses
Primary practice location
710 E Holland Ave Ste 6
Alpine, TX 79830-5007
Mailing address
2525 N Grandview Ave Ste 400
Odessa, TX 79761-1621
Phone (432) 550-4700
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 |
|---|---|---|---|
| 4052871 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phytex Rehabilitation, LLC | Past | Accepting new patients |
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.
-
dba PhyTEx Rehabilitation & Sports Medicine Associates
- Physical Therapist
- Humble, TX
- NPI 1366937591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1699188466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 N GRANDVIEW AVE STE 400",
"city": "ODESSA",
"state": "TX",
"postal_code": "797611621",
"telephone_number": "432-550-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 E HOLLAND AVE STE 6",
"city": "ALPINE",
"state": "TX",
"postal_code": "798305007",
"telephone_number": "432-837-5918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREVIZO",
"first_name": "CRUZ",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-09",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "4052871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alpine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.