Individual provider Active NPI

Alisa Phommavong

  • Physical Therapist
  • Austin, TX
National Provider Identifier
1154273522
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
6836 Austin Center Blvd Ste 1-180
Austin, TX 78731-3188
Phone
(512) 225-1002
Fax
(512) 501-4021
NPI assigned
Feb 10, 2026
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TX Primary

Addresses

Primary practice location

6836 Austin Center Blvd Ste 1-180
Austin, TX 78731-3188

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (726) 202-3039

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260302000975 TX Practitioner - Physical Therapist in Private Practice 4880176767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Physical Therapy Specialists, IncGroup PAC ID 2567422538, 238 clinicians

Practice addresses (Care Compare)

6836 Austin Ctr Blvd
Suite 1180
Austin, TX 78731-3188
Phone (512) 225-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Physical Therapy Specialists CurrentSince Feb 20, 2026 Accepting new patients
Texas Physical Therapy Specialists, Inc. Physical Therapist CurrentSince Feb 20, 2026 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

6836 Austin Center Blvd
Ste 180
Austin, TX 78731
Phone (512) 225-1002

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1154273522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "726-202-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6836 AUSTIN CENTER BLVD STE 1-180",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313188",
            "telephone_number": "512-225-1002",
            "fax_number": "512-501-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOMMAVONG",
        "first_name": "ALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.