Destinee Budilo, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2149601 Issued in TX

Practice address

12708 Riata Vista Cir Ste A106
Austin, TX 78727-7174

Phone

(512) 795-2422

Fax

(512) 852-4485

NPI assigned

Mar 23, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Destinee King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1558064147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12708 RIATA VISTA CIR STE A106",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787277174",
            "telephone_number": "512-795-2422",
            "fax_number": "512-852-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12708 RIATA VISTA CIR STE A106",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787277174",
            "telephone_number": "512-795-2422",
            "fax_number": "512-852-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDILO",
        "first_name": "DESTINEE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2149601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESTINEE",
            "last_name": "KING",
            "prefix": "MISS",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Buckner Retirement Services, Inc.
• Hope J Buckner, LCSW
• Ronald A Buczek II, DO
• Surya Buddhi Manmadhudu
• Regina Budet, OTR
• Eric A Buehler, MD
• Scottie Hale Buehler, CPM, LM
• Alvin Troy Buemio, MD
• Evelyn Bueno
• Erick Buenrostro

• All providers in Austin, TX
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.