Individual provider Active NPI

Kathryn Elexis Villalobos, PTA

  • Physical Therapy Assistant
  • League City, TX
National Provider Identifier
1306567045
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2153818 Issued in TX
Practice address
1445 S Egret Bay Blvd Apt 450
League City, TX 77573-5704
Phone
(361) 696-9010
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2153818 TX Primary

Addresses

Primary practice location

1445 S Egret Bay Blvd Apt 450
League City, TX 77573-5704

Mailing address

1445 S Egret Bay Blvd Apt 450
League City, TX 77573-5704
Phone (361) 696-9010

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

LicenseStateTypeSpecialty
2153818TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1306567045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 S EGRET BAY BLVD APT 450",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735704",
            "telephone_number": "361-696-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 S EGRET BAY BLVD APT 450",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735704",
            "telephone_number": "361-696-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "KATHRYN",
        "middle_name": "ELEXIS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2153818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.