Active NPI
Hazem Othman
- Physical Therapist
- Richardson, TX
National Provider Identifier
1679955421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1254716
- Practice address
- 1301 Richardson Dr
Richardson, TX 75080-4648 - Phone
- (972) 759-2180
- NPI assigned
- Jun 28, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1254716 | TX | Primary |
Addresses
Primary practice location
1301 Richardson Dr
Richardson, TX 75080-4648
Mailing address
7605 Paddock TRL
Sachse, TX 75048-6699
Phone (540) 247-3112
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 |
|---|---|---|---|
| 1254716 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1679955421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7605 PADDOCK TRL",
"city": "SACHSE",
"state": "TX",
"postal_code": "750486699",
"telephone_number": "540-247-3112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 RICHARDSON DR",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750804648",
"telephone_number": "972-759-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTHMAN",
"first_name": "HAZEM",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-28",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1254716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.