Active NPI
Kara Gamboa
- Physical Therapist
- Rowlett, TX
National Provider Identifier
1366921165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1307699
- Practice address
- 3705 Lakeview Pkwy Ste 105
Rowlett, TX 75088-4178 - Phone
- (469) 443-0458
- NPI assigned
- Aug 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1307699 | TX | Primary |
Addresses
Primary practice location
3705 Lakeview Pkwy Ste 105
Rowlett, TX 75088-4178
Mailing address
9514 Heatherdale Dr
Dallas, TX 75243-6158
Phone (214) 608-6400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190124000936 | TX | Practitioner - Physical Therapist in Private Practice | 6406193788 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1307699 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546560000000",
"number": "1366921165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9514 HEATHERDALE DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752436158",
"telephone_number": "214-608-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3705 LAKEVIEW PKWY STE 105",
"city": "ROWLETT",
"state": "TX",
"postal_code": "750884178",
"telephone_number": "469-443-0458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBOA",
"first_name": "KARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-13",
"last_updated": "2019-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1307699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rowlett, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.