Christine Kaczmarek-Young, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1039931 Issued in TX

Practice address

255 N Egret Bay Blvd
League City, TX 77573-6533

Phone

(281) 525-4344

Fax

(281) 525-4320

NPI assigned

Jan 15, 2007

Last updated

Jan 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1144371352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12914 FM 1960 RD W STE F",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770655311",
            "telephone_number": "832-237-3331",
            "fax_number": "832-237-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N EGRET BAY BLVD",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775736533",
            "telephone_number": "281-525-4344",
            "fax_number": "281-525-4320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12914 Fm 1960 Rd W Ste F",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770655311",
            "country_code": "US",
            "telephone_number": "832-237-3331",
            "fax_number": "832-237-4638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACZMAREK-YOUNG",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1039931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "0052KX",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in League City, TX
• Providers in League City, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.