John Andrew Gonzaba
Individual provider Active NPI Physical Therapist · Dallas, TX
NPI 1902579485 · NPPES record last updated Oct 8, 2021
Key facts
- NPI
- 1902579485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 8081 Walnut Hill LN Ste 1000
Dallas, TX 75231-4313 - Phone
- (737) 932-3446
- NPI assigned
- Jul 29, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211014002979 | TX | Practitioner - Physical Therapist in Private Practice | 3870991219 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ap Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Texas Luna Care Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | |||
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
8081 Walnut Hill LN Ste 1000
Dallas, TX 75231-4313
Mailing address
8081 Walnut Hill LN Ste 1000
Dallas, TX 75231-4313
Phone (214) 239-0993
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.