Palak Y Panchal, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

CP004753A Issued in TX

Practice address

901 Pennsylvania Ave
Fort Worth, TX 76104-2226

Phone

(817) 335-3030

NPI assigned

Mar 3, 2022

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

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": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1811644404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8133 CHARFORD DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761311638",
            "telephone_number": "734-353-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042226",
            "telephone_number": "817-335-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 S Adams St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761041003",
            "country_code": "US",
            "telephone_number": "817-335-5781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "PALAK",
        "middle_name": "Y",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "10859913-2402",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "CP004753A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamba Solutions LLC
• Mohan Ramkumar Pamerla, M.D.
• Stephen Pan
• Kyriacos Panayides, MD
• Olivia Panchal
• Krishna Pancham, M.D
• Pancho Independent Pharmacy Inc (Creekwood Pharmacy)
• Pancho Independent Pharmacy, Inc (Rosedale pharmacy)
• Manish Pandey, MD
• Sarada Pandey

• Physical Therapy Assistant in Fort Worth, TX
• Providers in Fort Worth, 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 5, 2023; 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.