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JEDIDIAH LAGOS TAN, RPT, DPT

Deactivated

JEDIDIAH LAGOS TAN, RPT, DPT is a Physical Therapy Assistant healthcare provider located in PEARLAND, Texas. NPI 1114506110 is deactivated in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · PEARLAND, TX

This NPI has been deactivated. The record was deactivated on March 19, 2022. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1114506110
Provider Type
Individual
Gender
Male
NPI Issued
Apr 6, 2021 (0.95068493150685 yrs)
Last Updated
Jul 29, 2022
Deactivated
Mar 19, 2022
License
1342184 (TX)

Practice Information

Address
4102 VETERANS DR
PEARLAND, TX, 775842950
Browse TX providers · Browse ZIP 77584
Phone
8323790668
Primary Specialty
Physical Therapy Assistant
225100000X

Other Physical Therapy Assistant Providers in PEARLAND, TX

Name Credential NPI
ANDRE WARRICK YAPTANGCO P.T. 1750336517
STEPHANIE ALLISON WASKO PT 1386680544
KATHERINE LEIGH SPURGERS P.T 1760412001
AMY HUDAK PT 1932119518
MR. RAANAN LEVY PT 1871603761
BRENDA SHOEMAKER PT 1194821439
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.