Lisa C Pruett, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2136106 Issued in TX

Practice address

1500 N Lakeline Blvd
Cedar Park, TX 78613-6788

Phone

(512) 817-1842

NPI assigned

Oct 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1871256503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 GLACIAL STREAM LN",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137665",
            "telephone_number": "737-529-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N LAKELINE BLVD",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786136788",
            "telephone_number": "512-817-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "LISA",
        "middle_name": "C",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2136106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Procare Healing Centers, LLP
• Procare Healing Centers, LLP (Ciara Medical Equipment Company)
• Leslie Kay Proctor, R.D., L.D.
• Hannah Proffitt
• Propel Physical Therapy Services LLC
• Enas L Pruitt, M.D.
• Psa Ambulatory Surgical Center of Austin LLC
• Psa Ambulatory Surgical Center of North Austin LLC
• Psynthesis, PC
• PT Liftology

• Physical Therapy Assistant in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.