Gaolatlhe Moyambo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1108744 Issued in TX

Practice address

1900 Pine St
Abilene, TX 79601-2432

Phone

(325) 670-2000

NPI assigned

Mar 21, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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": "1237593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237593600000",
    "number": "1730320755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILDFLOWER BLVD",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545173",
            "telephone_number": "512-785-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 PINE ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012432",
            "telephone_number": "325-670-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYAMBO",
        "first_name": "GAOLATLHE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-21",
        "last_updated": "2009-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1108744",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00562300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT13055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Moser
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• Robert Bruce Mullins
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• Alicia Marie Munoz, COTA/L

• Physical Therapist in Abilene, TX
• Providers in Abilene, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2009; 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.