Active NPI
Amber Peck, P.T.
- Physical Therapist
- Southlake, TX
National Provider Identifier
1467878488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1142255
- Practice address
- 101 Watermere Dr
Southlake, TX 76092-8116 - Phone
- (817) 437-8668
- NPI assigned
- Mar 14, 2014
- 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 | 1142255 | TX | Primary |
Addresses
Primary practice location
101 Watermere Dr
Southlake, TX 76092-8116
Mailing address
11877 Vienna Apple Rd
Fort Worth, TX 76244-7574
Phone (214) 682-3750
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1142255 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1467878488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11877 VIENNA APPLE RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762447574",
"telephone_number": "214-682-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WATERMERE DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760928116",
"telephone_number": "817-437-8668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECK",
"first_name": "AMBER",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1142255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
- PCT Speech Therapy PLLC
- PDH Corporation (Pur Life Medical Southlake)
- Peace Psychology Center PLLC
- Peak Physical Therapy, LLC
- Erica Jean Pearson, DC
- Daniel Peckenpaugh, MD
- Pediaplex Management Company LLC
- Pediatric Ambulatory Surgery Center Southlake
- Pediatric Speech Stars, PLLC
- Caitlin Elizabeth Pedigo, RNFA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.