Tarek Ibrahim

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1086569 Issued in TX

Practice address

180 State St Ste 225
Southlake, TX 76092-7632

Phone

(866) 839-6979

NPI assigned

Oct 27, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Luna Care Physical Therapy LLCGroup PAC ID 0648692723, 271 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Texas Luna Care Physical Therapy LLC

  • Physical Therapist
  • Southlake, TX
  • NPI 1790309656
  Medicare reassignment Care Compare group NPD
• Baylor College of Medicine

  • Ph.D. Medical Genetics
  • Houston, TX
  • NPI 1881026664
  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • North Richland Hills, TX
  • NPI 1427454164
  Medicare reassignment NPD
• Baylor College of Medicine

  • Orthopaedic Surgery Physician
  • Sugar Land, TX
  • NPI 1700683844
  NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD
• Consultation Physical Therapy of Texas, P.C.

  • Physical Therapist
  • Houston, TX
  • NPI 1376714568
  NPD (past)

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1790449536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 STATE ST STE 225",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 STATE ST STE 225",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927632",
            "telephone_number": "866-839-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "TAREK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1086569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Huynh, PA-C
• My Huynh, FNP
• Thien Huynh, PHARM.D.
• Hwa Tow Acupuncture and Oriental Medicine Inc.
• Christian Ibe
• Ideal Dental of Southlake, PLLC
• Laura C Iglesias
• Asher S. Imam, D.O.
• Infinity Functional Performance
• Natalie Ingravallo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.