Individual provider Active NPI

Kayla Panos, DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Conroe, TX
National Provider Identifier
1396213856
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
1308587 Issued in TX
Practice address
17600 Interstate 45 S
Conroe, TX 77384-5148
Phone
(936) 267-7391
NPI assigned
Nov 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 1308587 TX Primary

Addresses

Primary practice location

17600 Interstate 45 S
Conroe, TX 77384-5148

Mailing address

2125 Yale St Apt 327
Houston, TX 77008-2672
Phone (512) 912-6800

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
1308587TXMDSports Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1396213856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 YALE ST APT 327",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770082672",
            "telephone_number": "512-912-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17600 INTERSTATE 45 S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773845148",
            "telephone_number": "936-267-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOS",
        "first_name": "KAYLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "1308587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.