NPIMap

Organization Active NPI

Federal Road Rehab & Diagnostic Inc

Doing business as Northshore Aquatherapy

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1376670265
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1013647 Issued in TX
Legal business name
FEDERAL ROAD REHAB & DIAGNOSTIC INC
Doing business as
Northshore Aquatherapy
Practice address
12655 Woodforest Blvd Ste 100
Houston, TX 77015-3575
Phone
(713) 455-2535
Fax
(713) 451-1411
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Authorized official

Name
Dr. William J Kowalski, DCNPI 1457403172
Title
Owner
Phone
(713) 451-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X 2889 TX
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1013647 TX Primary

Addresses

Primary practice location

12655 Woodforest Blvd Ste 100
Houston, TX 77015-3575

Mailing address

12655 Woodforest Blvd
Suite #100
Houston, TX 77015-3564
Phone (713) 455-2535

Other identifiers 5

IdentifierTypeStateIssuer
328188800OtherTXDOL
0091KKOtherTXBC/ BS GRP #
045155001MedicaidTX
CS4064OtherTXMEDICARE RAILROAD
350017778OtherTXRAILROAD MEDICARE

Other names 1

  • NORTHSHORE AQUATHERAPY Doing business as

National Provider Directory

National Provider Directory

Locations

12655 Woodforest Blvd
Ste 100
Houston, TX 77015
Phone (713) 455-2535

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1376670265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 WOODFOREST BLVD",
            "address_2": "SUITE #100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153564",
            "telephone_number": "713-455-2535",
            "fax_number": "713-451-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 WOODFOREST BLVD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153575",
            "telephone_number": "713-455-2535",
            "fax_number": "713-451-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERAL ROAD REHAB & DIAGNOSTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "KOWALSKI",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-451-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "TX",
            "license": "2889",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1013647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "328188800",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/ BS  GRP #",
            "identifier": "0091KK",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045155001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CS4064",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350017778",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHSHORE AQUATHERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.