Active NPI
Dayna Wall
- Physical Therapy Assistant
- Nacogdoches, TX
National Provider Identifier
1710467402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2047710
- Practice address
- 611 NE Stallings Dr
Nacogdoches, TX 75961-5952 - Phone
- (936) 564-1134
- NPI assigned
- Aug 21, 2018
- Last updated
- Aug 21, 2018
- Sex
- Female
- 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 | 2047710 | TX | Primary |
Addresses
Primary practice location
611 NE Stallings Dr
Nacogdoches, TX 75961-5952
Mailing address
1756 FM 1087
Nacogdoches, TX 75965-8660
Phone (936) 596-6180
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 |
|---|---|---|---|
| 2047710 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534809600000",
"number": "1710467402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1756 FM 1087",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759658660",
"telephone_number": "936-596-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 NE STALLINGS DR",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759615952",
"telephone_number": "936-564-1134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "DAYNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-21",
"last_updated": "2018-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2047710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-4674)
- Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0163)
- Wal-Mart Stores Texas, LP (Vision Center 30-0163)
- Walgreen Co (Walgreens #09400)
- Latoya Walker, MA
- Gregory Scott Wallis, CRNA
- Aisha Ligon Warfield, APRN
- Warthan Dermatology Center
- Warthan Dermatology Nacogdoches PLLC
- T Lynn Warthan, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.