Individual provider Active NPI

Theodora Efroseni Tsakalakis, ATC

  • Athletic Trainer
  • Houston, TX
National Provider Identifier
1558890962
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000027672 Issued in TX
Practice address
15722 Dunmoor Dr.
Houston, TX 77059
Phone
(281) 480-2070
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000027672 TX Primary

Addresses

Primary practice location

15722 Dunmoor Dr.
Houston, TX 77059

Mailing address

15722 Dunmoor Dr
Houston, TX 77059-3802

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

LicenseStateTypeSpecialty
2000027672TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1558890962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15722 DUNMOOR DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770593802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15722 DUNMOOR DR.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77059",
            "telephone_number": "281-480-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAKALAKIS",
        "first_name": "THEODORA",
        "middle_name": "EFROSENI",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "2000027672",
            "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 Jun 8, 2017; 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.