Individual provider Active NPI

Myah Arlette Roberson, LMT

  • Mechanotherapist
  • Houston, TX
National Provider Identifier
1902188121
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
112531 Issued in TX
Practice address
5419 Ennis Avenue
#4
Houston, TX 77004
Phone
(713) 456-0626
NPI assigned
Sep 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 112531 TX Primary

Addresses

Primary practice location

5419 Ennis Avenue
#4
Houston, TX 77004

Mailing address

PO Box 8172
Houston, TX 77288-8172
Phone (713) 456-0626

Other identifiers 1

IdentifierTypeStateIssuer
112531OtherTXMECHANO THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
112531TXMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1902188121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8172",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772888172",
            "telephone_number": "713-456-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 ENNIS AVENUE",
            "address_2": "#4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77004",
            "telephone_number": "713-456-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "MYAH",
        "middle_name": "ARLETTE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "TX",
            "license": "112531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MECHANO THERAPIST",
            "identifier": "112531",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.