Elena Misa Angus, PT
Individual provider Active NPI Physical Therapist · Lytle, TX
NPI 1891960498 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1891960498
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1050466 (TX)
- Practice address
- 19965 FM 3175
Lytle, TX 78052-3481 - Phone
- (210) 357-0395
- Fax
- (830) 709-5493
- NPI assigned
- Apr 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1050466 | TX | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1050466 | TX | Yes |
Addresses
Primary practice location
19965 FM 3175
Lytle, TX 78052-3481
Mailing address
PO Box 725
Lytle, TX 78052-0725
Phone (210) 357-0395
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1050466 | Other | TX | LICENSE NUMBER |
Other providers in Lytle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.