Katherine Stella Gordon Campos

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2142543 Issued in TX

Practice address

127 Medical Park LN
Huntsville, TX 77340-4972

Phone

(936) 294-0283

NPI assigned

Dec 3, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wilco Theranet, LLC

  dba Physical Therapy Associates

  • Specialist
  • Huntsville, TX
  • NPI 1679667695
  NPD
• Physical Therapy Associates

  • Specialist
  • Huntsville, TX
  • NPI 1659547107
  NPD (past)

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1689490864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 N LOOP 336 W APT 5311",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043470",
            "telephone_number": "936-276-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MEDICAL PARK LN",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404972",
            "telephone_number": "936-294-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON CAMPOS",
        "first_name": "KATHERINE",
        "middle_name": "STELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2142543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Rene Golden, FNP
• Cory Joplin Gonzales, SLP
• Janet Gonzalez, PHARMD
• Katharyn Goosmann, CCC-SLP
• Anisa Faruk Gopalani, M.D.
• Greater Horizons 1 Texas LP (The Lexington Center)
• Jamie Nicole Green, APRN, FNP-C
• Najla Rashidah Green, NP
• Christopher David Greenleaf, PH.D., LAT,ATC, CSCS
• Gregory D Peter D.C. PA

• Physical Therapy Assistant in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.