Active NPI
Dustin Gault, PTA
- Mechanotherapist
- Lubbock, TX
National Provider Identifier
1932592789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 2097086
- Practice address
- 7307 University Ave
Lubbock, TX 79423-1422 - Phone
- (806) 412-4200
- Fax
- (806) 412-4201
- NPI assigned
- Mar 17, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 2097086 | TX | Primary |
Addresses
Primary practice location
7307 University Ave
Lubbock, TX 79423-1422
Mailing address
7307 University Ave
Lubbock, TX 79423-1422
Phone (806) 412-4200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2097086 | TX | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426550400000",
"number": "1932592789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7307 UNIVERSITY AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794231422",
"telephone_number": "806-412-4200",
"fax_number": "806-412-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7307 UNIVERSITY AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794231422",
"telephone_number": "806-412-4200",
"fax_number": "806-412-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAULT",
"first_name": "DUSTIN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-17",
"last_updated": "2015-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "TX",
"license": "2097086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.