Active NPI
Rusty Mikolas, ATP
- Other Technician
- Houston, TX
National Provider Identifier
1508407966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 90894
- Practice address
- 9494 Kirby Dr
Houston, TX 77054-2521 - Phone
- (713) 791-9080
- Fax
- (713) 791-9084
- NPI assigned
- Oct 7, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 90894 | TX | Primary |
Addresses
Primary practice location
9494 Kirby Dr
Houston, TX 77054-2521
Mailing address
5959 Shallowford Rd Ste 443
Chattanooga, TN 37421-2245
Phone (423) 756-2268
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
| License | State | Type | Specialty |
|---|---|---|---|
| 90894 | TX | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1508407966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 SHALLOWFORD RD STE 443",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374212245",
"telephone_number": "423-756-2268",
"fax_number": "423-362-5413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9494 KIRBY DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770542521",
"telephone_number": "713-791-9080",
"fax_number": "713-791-9084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKOLAS",
"first_name": "RUSTY",
"credential": "ATP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-07",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "TX",
"license": "90894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.