Active NPI
Tiwalade Obisesan
- Physical Therapy Assistant
- Sugar Land, TX
National Provider Identifier
1710295126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2077931
- Practice address
- 2323 Upland Park Dr
Sugar Land, TX 77479-7032 - Phone
- (832) 492-3818
- NPI assigned
- Sep 20, 2010
- Last updated
- Sep 20, 2010
- 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 | 2077931 | TX | Primary |
Addresses
Primary practice location
2323 Upland Park Dr
Sugar Land, TX 77479-7032
Mailing address
2323 Upland Park Dr
Sugar Land, TX 77479-7032
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 |
|---|---|---|---|
| 2077931 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1710295126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 UPLAND PARK DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774797032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 UPLAND PARK DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774797032",
"telephone_number": "832-492-3818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBISESAN",
"first_name": "TIWALADE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-20",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2077931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sugar Land, TX
- Robert Abraham Obeid, MD
- Anandita OB Oberoi
- Obiageli Clare Obijiofor, MD
- Patricia Obionwu, NURSE PRACTITIONER
- Adekunbi Obisesan, NP-C
- Jennifer Obrien, LCSW
- Obstetrical and Gynecological Associates (Sugarland The Womans Place)
- Obstetrical and Gynecological Associates
- Obstetrical and Gynecological Associates (Fertility Specialists of Houston)
- Alexandrea Ochoa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.