Komkrit Kaewchay

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

L3804 Issued in TX

Practice address

8501 N Macarthur Blvd
0582 C/O Consultant USA
Irving, TX 75063-4100

Phone

(469) 442-7405

NPI assigned

Dec 9, 2013

Last updated

Jan 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1699106112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2668 N BELT LINE RD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625245",
            "telephone_number": "972-513-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 N MACARTHUR BLVD",
            "address_2": "0582 C/O CONSULTANT USA",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750634100",
            "telephone_number": "469-442-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAEWCHAY",
        "first_name": "KOMKRIT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-09",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "L3804",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "L3804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Irving, TX
• Providers in Irving, TX by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.