Individual provider Active NPI

Leo Bantiling Garra III

  • Physical Therapist
  • Eagle Pass, TX
National Provider Identifier
1831053586
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1398540 Issued in TX
Practice address
2483 2ND St Ste B
Eagle Pass, TX 78852-4391
Phone
(830) 776-5191
Fax
(830) 776-5205
NPI assigned
Dec 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1398540 TX Primary

Addresses

Primary practice location

2483 2ND St Ste B
Eagle Pass, TX 78852-4391

Mailing address

2101 N 23Rd St
McAllen, TX 78501-6127
Phone (956) 687-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260213000038 TX Practitioner - Physical Therapist in Private Practice 4587144266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Therapeutics - Eagle Pass, PLLCGroup PAC ID 7810134541, 3 clinicians

Practice addresses (Care Compare)

2483 2ND St
Suite B
Eagle Pass, TX 78852-4391
Phone (830) 776-5181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1398540TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Therapeutics - Eagle Pass, PLLC Physical Therapist CurrentSince Jan 5, 2026 Accepting new patients

Locations

2483 2nd St
Ste B
Eagle Pass, TX 78852
Phone (830) 776-5181

2101 N 23rd St
McAllen, TX 78501

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1831053586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N 23RD ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016127",
            "telephone_number": "956-687-4559",
            "fax_number": "956-687-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 2ND ST STE B",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524391",
            "telephone_number": "830-776-5191",
            "fax_number": "830-776-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRA",
        "first_name": "LEO",
        "middle_name": "BANTILING",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1398540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.