Individual provider Active NPI

Brian Kim, PT, DPT

  • Physical Therapist
  • Lakewood Village, TX
National Provider Identifier
1487563110
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1370772 Issued in TX
Practice address
410 Cherry Laurel Dr
Lakewood Village, TX 75068-4516
Phone
(630) 854-7466
NPI assigned
Sep 8, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1370772 TX Primary

Addresses

Primary practice location

410 Cherry Laurel Dr
Lakewood Village, TX 75068-4516

Mailing address

410 Cherry Laurel Dr
Lakewood Village, TX 75068-4516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1487563110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CHERRY LAUREL DR",
            "city": "LAKEWOOD VILLAGE",
            "state": "TX",
            "postal_code": "750684516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHERRY LAUREL DR",
            "city": "LAKEWOOD VILLAGE",
            "state": "TX",
            "postal_code": "750684516",
            "telephone_number": "630-854-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BRIAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1370772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.