Individual provider Active NPI

Matthew John Mielak, PTA

  • Physical Therapy Assistant
  • Sealy, TX
National Provider Identifier
1982503314
Registry record updated Nov 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2158488 Issued in TX
Practice address
3701 Outlet Center Dr Ste 50
Sealy, TX 77474-4907
Phone
(979) 627-7774
NPI assigned
Nov 3, 2026
Last updated
Nov 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2026

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 2158488 TX Primary

Addresses

Primary practice location

3701 Outlet Center Dr Ste 50
Sealy, TX 77474-4907

Mailing address

3701 Outlet Center Dr Ste 50
Sealy, TX 77474-4907
Phone (979) 627-7774

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1793664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793664000000",
    "number": "1982503314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 OUTLET CENTER DR STE 50",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774744907",
            "telephone_number": "979-627-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 OUTLET CENTER DR STE 50",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774744907",
            "telephone_number": "979-627-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELAK",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-11-03",
        "last_updated": "2026-11-03",
        "certification_date": "2026-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2158488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sealy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.