Stephen Kagondu Waigwa, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2082367 Issued in TX

Practice address

1755 Curie Dr
# A
El Paso, TX 79902-2919

Phone

(915) 544-3636

NPI assigned

Sep 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1730460635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 PHOENIX AVE",
            "address_2": "APT 46",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799151932",
            "telephone_number": "915-227-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 CURIE DR",
            "address_2": "# A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799022919",
            "telephone_number": "915-544-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIGWA",
        "first_name": "STEPHEN",
        "middle_name": "KAGONDU",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2082367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Aaron Waggoner, PHD
• Elizabeth H. Wagner, MS, ATC,LAT
• Emily Wagner
• Linda Wagner, LPC
• Sterling Michael Wahlrab
• Wainwright Family Resource Center (WFRC)
• Cornelius W. Wakefield, M.D.
• Catherine Davenportpollock Wakeham, MD
• Connor Wakeham
• Biruk Getachew Wakjira, MD

• Physical Therapy Assistant in El Paso, TX
• Providers in El Paso, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.