Active NPI
Allen Miranda Geneta, PTA
- Physical Therapy Assistant
- Sugar Land, TX
National Provider Identifier
1760966618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2091509
- Practice address
- 1803 Westcott Ave
Sugar Land, TX 77479-4680 - Phone
- (281) 329-4300
- NPI assigned
- Sep 17, 2018
- Sex
- Male
- 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 | 2091509 | TX | Primary |
Addresses
Primary practice location
1803 Westcott Ave
Sugar Land, TX 77479-4680
Mailing address
17114 Simon CT
Richmond, TX 77407-2600
Phone (832) 686-1646
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 |
|---|---|---|---|
| 2091509 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537142400000",
"number": "1760966618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17114 SIMON CT",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774072600",
"telephone_number": "832-686-1646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 WESTCOTT AVE",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774794680",
"telephone_number": "281-329-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENETA",
"first_name": "ALLEN",
"middle_name": "MIRANDA",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-17",
"last_updated": "2018-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2091509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.