Tristan Ezeoke, PT, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1350306 Issued in TX

Practice address

4620 Center St
Houston, TX 77007

Phone

(832) 356-9727

NPI assigned

Oct 15, 2021

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

Locations

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.

• Injury2Victory

  • Physical Therapist
  • Houston, TX
  • NPI 1447913512

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1487317673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 UPLAND DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770434718",
            "telephone_number": "832-356-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 CENTER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77007",
            "telephone_number": "832-356-9727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12155 Shadow Creek Pkwy Ste 111",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "775847289",
            "country_code": "US",
            "telephone_number": "832-356-9727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZEOKE",
        "first_name": "TRISTAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "1350306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nkoli Ezenwa
• Vivian Ezenwa
• Obiajulu Cletus Ezenwabachili, M.D.
• Benedicta Ezenwenyi, PMHNP
• Vidah Ifeoma Ezeoka
• Uzoamaka Ezeokeke
• Lenore Ruth Ezernack, DDS
• Richard Wayne Ezernack, P.T.
• Chinonso Bright Ezeudu
• Nathalie Ezeudu, FNP

• Physical Medicine & Rehabilitation Physician in Houston, TX
• Providers in Houston, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.