Active NPI
Beaelisa Suzette Duchamp, P.T.
- Physical Therapist
- Live Oak, TX
National Provider Identifier
1831522341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1232143
- Practice address
- 7909 Pat Booker Rd
Live Oak, TX 78233-2602 - Phone
- (210) 653-2400
- Fax
- (210) 653-2422
- NPI assigned
- Aug 20, 2013
- 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 Therapist | 225100000X | 1232143 | TX | Primary |
Addresses
Primary practice location
7909 Pat Booker Rd
Live Oak, TX 78233-2602
Mailing address
8627 Cinnamon Creek Dr
Suite 402
San Antonio, TX 78240-1480
Phone (210) 372-0211
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1232143 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1831522341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8627 CINNAMON CREEK DR",
"address_2": "SUITE 402",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401480",
"telephone_number": "210-372-0211",
"fax_number": "210-888-1279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7909 PAT BOOKER RD",
"city": "LIVE OAK",
"state": "TX",
"postal_code": "782332602",
"telephone_number": "210-653-2400",
"fax_number": "210-653-2422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCHAMP",
"first_name": "BEAELISA",
"middle_name": "SUZETTE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-20",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1232143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Live Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.