NPIMap

Organization Active NPI

Pediatric Therapeas PLLC

  • Pediatric Physical Therapist
  • Tyler, TX
National Provider Identifier
1710324025
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1098895 Issued in TX
Legal business name
PEDIATRIC THERAPEAS PLLC
Practice address
4801 Troup Hwy Ste 800
Tyler, TX 75703-2357
Phone
(903) 525-9130
NPI assigned
May 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Mr. Dennis Michael KressNPI 1982896965
Title
Owner
Phone
(903) 521-3350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X 1098895 TX Primary

Addresses

Primary practice location

4801 Troup Hwy Ste 800
Tyler, TX 75703-2357

Mailing address

4801 Troup Hwy Ste 800
Tyler, TX 75703-2357
Phone (903) 525-9130

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1710324025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY STE 800",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032357",
            "telephone_number": "903-525-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY STE 800",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032357",
            "telephone_number": "903-525-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPEAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "KRESS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-521-3350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1098895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.