Individual provider Active NPI

Juan B. Holguin, PTA

  • Physical Therapy Assistant
  • Pflugerville, TX
National Provider Identifier
1750579868
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2046381 Issued in TX
Practice address
104 Rex Kerwin CT
Pflugerville, TX 78660
Phone
(512) 251-3915
Fax
(512) 291-9884
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2046381 TX Primary

Addresses

Primary practice location

104 Rex Kerwin CT
Pflugerville, TX 78660

Mailing address

101 W Goodwin Ave
Victoria, TX 77901-6502

Other practice location 1

2700 Sunrise Rd
Round Rock, TX 78665-9323
Phone (512) 244-0236

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

LicenseStateTypeSpecialty
2046381TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1750579868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W GOODWIN AVE",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 REX KERWIN CT",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "78660",
            "telephone_number": "512-251-3915",
            "fax_number": "512-291-9884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Sunrise Rd",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786659323",
            "country_code": "US",
            "telephone_number": "512-244-0236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLGUIN",
        "first_name": "JUAN",
        "middle_name": "B.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2046381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pflugerville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.