Individual provider Active NPI

Thomas Tydlacka, PT, DPT

  • Orthopedic Physical Therapist
  • Cypress, TX
National Provider Identifier
1114568359
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
21216 Northwest Fwy Ste 620
Cypress, TX 77429-4699
Phone
(281) 807-4380
Fax
(833) 521-2189
NPI assigned
Sep 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

21216 Northwest Fwy Ste 620
Cypress, TX 77429-4699

Mailing address

3023 Marina Bay Dr Ste 105
League City, TX 77573-2882
Phone (713) 943-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250823000296 TX Practitioner - Physical Therapist in Private Practice 7517467632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4700 Seton Ctr Pkwy
Suite 115
Austin, TX 78759-5753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Jul 21, 2025 Accepting new patients
Ortholonestar, PLLC CurrentSince Jul 21, 2025 Accepting new patients
Ortholonestar, PLLC Past Accepting new patients
Webster Surgical Specialty Hospital, LLC PastSince Oct 1, 2019 Accepting new patients

Locations

4700 Seton Center Pkwy
Ste 115
Austin, TX 78759
Phone (346) 440-0644

2635 W Baker Rd
Baytown, TX 77521
Phone (281) 337-8550

21216 Northwest Fwy
Ste 620
Cypress, TX 77429
Phone (281) 469-7704

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

3023 Marina Bay Dr
Ste 105
League City, TX 77573
Phone (281) 549-6404

10223 Broadway St
Ste A
Pearland, TX 77584
Phone (713) 436-3488

520 Blossom St
Webster, TX 77598
Phone (281) 332-9537

Interoperability endpoints

  • Direct secure messaging: thomas.tydlacka.1@15533.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1114568359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 MARINA BAY DR STE 105",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732882",
            "telephone_number": "713-943-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21216 NORTHWEST FWY STE 620",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294699",
            "telephone_number": "281-807-4380",
            "fax_number": "833-521-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYDLACKA",
        "first_name": "THOMAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-29",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.