Traveling Age

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2115702 Issued in TX

Legal business name

TRAVELING AGE

Practice address

901 NE Loop 410
Suite 100
San Antonio, TX 78209-1305

Phone

(267) 902-7537

NPI assigned

Jul 20, 2016

Last updated

Jul 20, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Takeitha A. Moye, PTA

Title

Pta

Phone

(267) 902-7537

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1831542240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10842 GREEN LAKE ST",
            "address_2": "LOT #93",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782234240",
            "telephone_number": "267-902-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NE LOOP 410",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091305",
            "telephone_number": "267-902-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVELING AGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "TAKEITHA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PTA",
        "authorized_official_telephone_number": "267-902-7537",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "2115702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.