NPIMap

Organization Active NPI

Therapeutic Lifestyle

  • Physical Therapist
  • Mission, TX
National Provider Identifier
1851552228
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1118529 Issued in TX
Legal business name
THERAPEUTIC LIFESTYLE
Practice address
904 Las Brisas Dr
Mission, TX 78574-0425
Phone
(956) 400-5877
Fax
(956) 424-3535
NPI assigned
Jun 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mr. Stephen Walter Donnellon, P.T.NPI 1093985517
Title
P.T/Owner
Phone
(956) 400-5877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1118529 TX Primary

Addresses

Primary practice location

904 Las Brisas Dr
Mission, TX 78574-0425

Mailing address

904 Las Brisas Dr
Mission, TX 78574-0425
Phone (956) 400-5877

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1851552228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 LAS BRISAS DR",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785740425",
            "telephone_number": "956-400-5877",
            "fax_number": "956-424-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 LAS BRISAS DR",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785740425",
            "telephone_number": "956-400-5877",
            "fax_number": "956-424-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC LIFESTYLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "DONNELLON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "P.T/OWNER",
        "authorized_official_telephone_number": "956-400-5877",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1118529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.