Leah Faith Boutros, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT35430 Issued in FL

Practice address

3100 Olympus Blvd. Suite 500
Dallas, TX 75019

Phone

(877) 456-2867

NPI assigned

Feb 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Leah Faith Fifelski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1780140467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 S BADOUR RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486409565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OLYMPUS BLVD. SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "877-456-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "LEAH",
        "middle_name": "FAITH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1312434",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "FIFELSKI",
            "middle_name": "FAITH",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Bourque, OPTOMETRIST
• Mamawah Isata Bourque, P.T.
• Launa Bouseman
• Andrea Marie Bousquet, LBSW
• Mary Grace Boustany Barnidge, PA-C
• Jeffrey Boutte, LSA
• Joshua Rene Boutte, LPC
• Leslie Moses Boutte, LPC-S, RPT-S
• Grace Zupfer Bouvier, MSN, APRN, AGACNP-BC
• Sifallah Bachir Bouyadjera

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.