Individual provider Active NPI

Pamela O'Neal Wayne, PT

  • Physical Therapist
  • Pearland, TX
National Provider Identifier
1902496995
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1143576 Issued in TX
Practice address
2011 Broadway St Ste 130
Pearland, TX 77581-5945
Phone
(281) 997-8509
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1143576 TX Primary

Addresses

Primary practice location

2011 Broadway St Ste 130
Pearland, TX 77581-5945

Mailing address

3634 Quiet Meadow CT
Manvel, TX 77578-4849
Phone (832) 259-4059

Other practice location 1

4635 Southwest Freeway, St 182
Houston, TX 77027
Phone (713) 850-0088

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
1143576TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tritrax Therapy, Inc Past Accepting new patients
Riverkids Houston Therapy, LLC PastSince Sep 23, 2024 Accepting new patients
Sandra Sands-Arnaez Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1902496995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 QUIET MEADOW CT",
            "city": "MANVEL",
            "state": "TX",
            "postal_code": "775784849",
            "telephone_number": "832-259-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BROADWAY ST STE 130",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815945",
            "telephone_number": "281-997-8509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4635 Southwest Freeway, St 182",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77027",
            "country_code": "US",
            "telephone_number": "713-850-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "PAMELA",
        "middle_name": "O'NEAL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1143576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.