Webster Sports Medicine and Injury Clinic LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

WEBSTER SPORTS MEDICINE AND INJURY CLINIC LLC

Practice address

202 N Texas Ave Ste 400
Webster, TX 77598-4967

Phone

(806) 701-9999

NPI assigned

Jan 15, 2021

Organization subpart

No

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

Authorized official

Name

Nita Pancholi

Title

Administrator

Phone

(678) 687-7494

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1851980502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N TEXAS AVE STE 400",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N TEXAS AVE STE 400",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984967",
            "telephone_number": "806-701-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBSTER SPORTS MEDICINE AND INJURY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "PANCHOLI",
        "authorized_official_first_name": "NITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-687-7494"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyonna Watson, FNP-C
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• Alicia Weffer, PTA
• Diane Lynn Wegelt-Wundrow, CRNA
• Jacqueline Marie Wegge, MD
• Lindsay Weinmann

• Physical Therapist in Webster, TX
• Providers in Webster, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.