Individual provider Active NPI

Kristoffer Pacheco

  • Physical Therapy Assistant
  • Spring, TX
National Provider Identifier
1578953907
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2083486 Issued in TX
Practice address
4650 S Panther Creek Dr
Spring, TX 77381-2764
Phone
(281) 363-3535
NPI assigned
Jan 22, 2015
Last updated
Jan 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2083486 TX Primary

Addresses

Primary practice location

4650 S Panther Creek Dr
Spring, TX 77381-2764

Mailing address

8602 Cedar Walk Dr
Tomball, TX 77375-5604
Phone (713) 493-1279

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
2083486TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1578953907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8602 CEDAR WALK DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773755604",
            "telephone_number": "713-493-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 S PANTHER CREEK DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773812764",
            "telephone_number": "281-363-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "KRISTOFFER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2083486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.