THOMAS TYDLACKA (PT, DPT) – Orthopedic Physical Therapist, NPI 1114568359

THOMAS TYDLACKA (PT, DPT) is a healthcare provider. based in Belton, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. The NPI Number for THOMAS TYDLACKA (PT, DPT) is 1114568359

Main info

Male
7 Years Of Experience
Name
THOMAS TYDLACKA (PT, DPT)
NPI
1114568359
Phone
Not provided
Address
12310 BONNIE LN
Enumeration Date
29 September 2019
Last Update Date
11 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2019 (7 years ago)
PAC ID
7517467632
Professional Enrollment ID
I20250823000296
Address ID
TX787595753AU4700XPKWY401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness85
Years active:6State licenses:0Digital endpointsOther names

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

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Provider Addresses for THOMAS TYDLACKA (PT, DPT)

  • 12310 BONNIE LN

    BELTON, TX 765137377

    Phone:

    Type: Mailing

  • Marina Bay Drive, League City, Galveston County, Texas, 77565, United States

    LEAGUE CITY, TX 775732882

    Phone: (281) 549-6404

    Type: Location

  • 3023 MARINA BAY DR STE 105

    LEAGUE CITY, TX 775732882

    Phone: (713) 943-1100

    Type: Mailing

  • 21216 NORTHWEST FWY STE 620

    CYPRESS, TX 774294699

    Phone: (281) 807-4380

    Fax: (833) 521-2189

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250823000296IPhysical Therapist In Private PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76513)

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Reviews

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Frequently asked questions

Does THOMAS TYDLACKA (PT, DPT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — THOMAS TYDLACKA (PT, DPT) uses 1114568359.
Does CMS list THOMAS TYDLACKA (PT, DPT) as active?
Yes — THOMAS TYDLACKA (PT, DPT) is active in the NPI listing used on this page.
What is THOMAS TYDLACKA (PT, DPT)'s specialty?
The listing groups THOMAS TYDLACKA (PT, DPT) with Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is THOMAS TYDLACKA (PT, DPT) based?
THOMAS TYDLACKA (PT, DPT) is tied to Belton, Texas in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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