Active NPI
Susan Hudson
- Physical Therapy Assistant
- Garland, TX
National Provider Identifier
1750907929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2153612
- Practice address
- 930 W Centerville Rd Ste C
Garland, TX 75041-5854 - Phone
- (972) 303-7021
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 2153612 | TX | Primary |
Addresses
Primary practice location
930 W Centerville Rd Ste C
Garland, TX 75041-5854
Mailing address
305 NE Loop 280
Business Tower 1, Suite 200
Hurst, TX 76053
Phone (817) 292-8787
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 |
|---|---|---|---|
| 2153612 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1750907929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 280",
"address_2": "BUSINESS TOWER 1, SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "76053",
"telephone_number": "817-292-8787",
"fax_number": "817-789-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W CENTERVILLE RD STE C",
"city": "GARLAND",
"state": "TX",
"postal_code": "750415854",
"telephone_number": "972-303-7021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-23",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2153612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.