Amber Koustoumbardis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1149548 Issued in TX

Practice address

2764 S Lakeview Dr
Cedar Hill, TX 75104-8204

Phone

(214) 769-6580

NPI assigned

Jul 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Arlington Physical Therapy PC

  • Physical Therapist
  • Arlington, TX
  • NPI 1063422707
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1346693637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2764 S LAKEVIEW DR",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751048204",
            "telephone_number": "214-769-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2764 S LAKEVIEW DR",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751048204",
            "telephone_number": "214-769-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUSTOUMBARDIS",
        "first_name": "AMBER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1149548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Michelle Kimble, LVN
• Antoinette King
• Shadarion Kinsey, PMHNP
• Monica Kirkland
• Koble Hearing PLLC
• Kroger Texas L P
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• Sherrie Lacock
• Chistee Lacy, DC
• Emma Lapish, PTA

• Physical Therapist in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.