Individual provider Active NPI

Kenneth John Trzecki, PT, OCS

  • Physical Therapist
  • Humble, TX
National Provider Identifier
1841349016
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1167711 Issued in TX
Practice address
7155 Atascocita Rd
Humble, TX 77346-5014
Phone
(281) 812-8304
Fax
(281) 812-8306
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1167711 TX Primary

Addresses

Primary practice location

7155 Atascocita Rd
Humble, TX 77346-5014

Mailing address

7155 Atascocita Rd
Humble, TX 77346-5014
Phone (281) 812-8304

Other identifiers 1

IdentifierTypeStateIssuer
1167711OtherTXTX STATE PT LICENSE NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1167711TXMDPhysical Therapist
4316AZMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Institute of Physical Therapy Physical Therapist Past Accepting new patients
Sports Institute of Physical Therapy Past Accepting new patients
Southwest Therapy Specialists, P.C. PastSince Jul 19, 2008 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841349016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7155 ATASCOCITA RD",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773465014",
            "telephone_number": "281-812-8304",
            "fax_number": "281-812-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7155 ATASCOCITA RD",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773465014",
            "telephone_number": "281-812-8304",
            "fax_number": "281-812-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRZECKI",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "credential": "PT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1167711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX STATE PT LICENSE NUMBE",
            "identifier": "1167711",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.