Individual provider Active NPI

Todd Edward Koudelka, D.C.

  • Rehabilitation Chiropractor
  • Sugar Land, TX
National Provider Identifier
1972678407
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
10355 Issued in TX
Practice address
15200 Southwest Fwy
Suite 295
Sugar Land, TX 77478-3845
Phone
(281) 229-0612
Fax
(281) 412-4629
NPI assigned
Nov 21, 2006
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 10355 TX Primary

Addresses

Primary practice location

15200 Southwest Fwy
Suite 295
Sugar Land, TX 77478-3845

Mailing address

15200 Southwest Fwy Ste 295
Sugar Land, TX 77478-3865
Phone (281) 903-7008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000359 TX Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 4981870409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15200 Southwest Fwy
Suite 295
Sugar Land, TX 77478-3865
Phone (281) 903-7008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10355TXMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Koudelka Health Center, LLC CurrentSince Nov 16, 2011 Accepting new patients

Locations

15200 Southwest Fwy
Ste 29
Sugar Land, TX 77478

15200 Southwest Fwy
Ste 295
Sugar Land, TX 77478
Phone (281) 229-0612

Organizations & group practices 1

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1972678407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 SOUTHWEST FWY STE 295",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783865",
            "telephone_number": "281-903-7008",
            "fax_number": "281-903-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 SOUTHWEST FWY",
            "address_2": "SUITE 295",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783845",
            "telephone_number": "281-229-0612",
            "fax_number": "281-412-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUDELKA",
        "first_name": "TODD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "10355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.