NPIMap

Organization Active NPI

Galveston Physical Medicine PLLC

  • Physical Medicine & Rehabilitation Physician
  • Galveston, TX
National Provider Identifier
1861752214
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GALVESTON PHYSICAL MEDICINE PLLC
Practice address
2724 61St St
Suite 5
Galveston, TX 77551-8137
Phone
(409) 744-9355
Fax
(409) 744-9356
NPI assigned
May 19, 2012
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Chad DuchonNPI 1437263142
Title
Director
Phone
(409) 744-9355

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

2724 61St St
Suite 5
Galveston, TX 77551-8137

Mailing address

2724 61St St
Suite 5
Galveston, TX 77551-8137
Phone (409) 744-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120912000855 TX Part B Supplier - Clinic/Group Practice 1557519741 Receives reassigned benefits from 8 practitioners
Practice locations: Galveston, TX; Webster, TX

National Provider Directory

National Provider Directory

Locations

2724 61st St
Ste 5
Galveston, TX 77551
Phone (409) 744-9355

17080 Highway 3
Ste A
Webster, TX 77598
Phone (281) 557-5525

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1861752214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 61ST ST",
            "address_2": "SUITE 5",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775518137",
            "telephone_number": "409-744-9355",
            "fax_number": "409-744-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 61ST ST",
            "address_2": "SUITE 5",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775518137",
            "telephone_number": "409-744-9355",
            "fax_number": "409-744-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALVESTON PHYSICAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-19",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "DUCHON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "409-744-9355"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.