Active NPI
Devina Monique Mendez, PTA
- Physical Therapy Assistant
- Georgetown, TX
National Provider Identifier
1811182934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2060772
- Practice address
- 903 River Haven Dr.
Georgetown, TX 78626 - Phone
- (512) 930-4995
- NPI assigned
- Sep 11, 2007
- 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 | 2060772 | TX | Primary |
Addresses
Primary practice location
903 River Haven Dr.
Georgetown, TX 78626
Mailing address
11522 B Rustic Rock Dr.
Austin, TX 78750
Phone (512) 296-4925
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 |
|---|---|---|---|
| 2060772 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258502400000",
"number": "1811182934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11522 B RUSTIC ROCK DR.",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78750",
"telephone_number": "512-296-4925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 RIVER HAVEN DR.",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "78626",
"telephone_number": "512-930-4995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEZ",
"first_name": "DEVINA",
"middle_name": "MONIQUE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-11",
"last_updated": "2009-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2060772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.