Individual provider Active NPI

Christian Jay Villagran

  • Physical Therapy Assistant
  • Kerrville, TX
National Provider Identifier
1962088039
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2140767 Issued in TX
Practice address
135 Plaza Dr
Kerrville, TX 78028-2230
Phone
(830) 895-2626
NPI assigned
Mar 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2140767 TX Primary

Addresses

Primary practice location

135 Plaza Dr
Kerrville, TX 78028-2230

Mailing address

715 Chinkapin Dr
Fredericksburg, TX 78624-2391
Phone (830) 282-9037

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
2140767TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1962088039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CHINKAPIN DR",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786242391",
            "telephone_number": "830-282-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PLAZA DR",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780282230",
            "telephone_number": "830-895-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGRAN",
        "first_name": "CHRISTIAN",
        "middle_name": "JAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2140767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

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