Active NPI
Cheryl Diane Austin, PTA
- Physical Therapy Assistant
- Southlake, TX
National Provider Identifier
1063666378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2050549
- Practice address
- 101 Watermere Dr
Southlake, TX 76092-8116 - Phone
- (817) 431-8668
- NPI assigned
- Nov 13, 2008
- Last updated
- Nov 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2050549 | TX | Primary |
Addresses
Primary practice location
101 Watermere Dr
Southlake, TX 76092-8116
Mailing address
1315 Oak Hill Rd
Keller, TX 76248-4208
Phone (817) 676-3903
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 |
|---|---|---|---|
| 2050549 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226534400000",
"number": "1063666378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 OAK HILL RD",
"city": "KELLER",
"state": "TX",
"postal_code": "762484208",
"telephone_number": "817-676-3903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WATERMERE DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760928116",
"telephone_number": "817-431-8668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUSTIN",
"first_name": "CHERYL",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-13",
"last_updated": "2008-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2050549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
- Obadah Attar, DDS, DSCD
- Audiology Center of North Texas, LLC
- Audra D Boxma PA (Life Skills Counseling Center)
- Molly Kathryn Augustine, M.D.
- Amnah Aurangzeb, M.D.
- Autism Therapies LLC
- Avalyn Wellness and Ketamine LLC
- Avant-Garde Counseling & Coaching Center
- Avanti Counseling & Consulting
- Aventura Home Health LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.