SUDARUKS THANASIRIPONG – Physical Therapist, NPI 1265082655

SUDARUKS THANASIRIPONG is a healthcare provider. based in Houston, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 1074052 (TX). The NPI Number for SUDARUKS THANASIRIPONG is 1265082655

Main info

Female
39 Years Of Experience
Accepts Medicare Assignment
Name
SUDARUKS THANASIRIPONG
NPI
1265082655
Phone
Not provided
Address
14703 EAGLE VISTA DR STE 601
Enumeration Date
17 September 2019
Last Update Date
17 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7134236066
Graduation Year
1987 (39 years ago)
PAC ID
0648753426
Group Practice PAC ID
6204079163
Professional Enrollment ID
I20260310003356
Address ID
TX770571750HO6336XDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

5,399 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for SUDARUKS THANASIRIPONG

  • 14703 EAGLE VISTA DR STE 601

    HOUSTON, TX 770775393

    Phone:

    Mailing address matches the actual address.

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: 2026-03-10

PECOS data refreshed: 2026-06-15

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
I20260310003356IPhysical 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 77077)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204079163View full group profile
NameSpecialtyState
Qualified Speech Language PathologistTX
Occupational Therapist In Private PracticeTX
Qualified Speech Language PathologistTX
Physical Therapist In Private PracticeMN
Occupational Therapist In Private PracticeTX
Physical Therapist In Private PracticeAR
Qualified Speech Language PathologistLA
Physical Therapist In Private PracticeKY
Occupational Therapist In Private PracticeMO
Qualified Speech Language PathologistTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for SUDARUKS THANASIRIPONG?
SUDARUKS THANASIRIPONG — NPI 1265082655 — is the standard way to identify this listing.
Does CMS list SUDARUKS THANASIRIPONG as active?
Yes — SUDARUKS THANASIRIPONG is active in the NPI listing used on this page.
What is SUDARUKS THANASIRIPONG's primary classification?
Physical Therapist is the headline specialty for SUDARUKS THANASIRIPONG here. Clinical services aligned with this taxonomy classification.
What address line appears for SUDARUKS THANASIRIPONG?
SUDARUKS THANASIRIPONG's geographic hint is Houston, Texas in our summary view.
Is the information about SUDARUKS THANASIRIPONG up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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