Eli Jimenez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2116675 Issued in TX

Practice address

8615 Lullwater Dr
Dallas, TX 75238-4754

Phone

(214) 221-0444

NPI assigned

Aug 20, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1982184891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 PARKLAND AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358221",
            "telephone_number": "214-229-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 LULLWATER DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752384754",
            "telephone_number": "214-221-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ELI",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2116675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracy Jilson, WHCNP
• Oscar Alfredo Jimenez Iraheta, BCBA
• Juan M Jimenez-Oliva, M.D.
• Amanda Indalecia Jimenez, ACNP-AG
• Consuelo Emilia Jimenez
• Irma Cruz Jimenez, RN
• Johana Jimenez, LPC
• Makayla Jimenez
• Muriel Kim Jimenez, OTR
• Sebastian Jimenez

• Physical Therapy Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.