Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Raphael Augustus Sadiwa, PT, DPT

Individual provider Physical Therapist · NPI 1063245561

Raphael Augustus Sadiwa, PT, DPT is a Physical Therapist in Private Practice in Southlake, Texas. Qualified in 2007, 19 years ago. Practices with Texas Luna Care Physical Therapy LLC, a 267-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
19
Licensed in
TX
In the registry since
2024
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

180 State St Ste 225
Southlake, TX 76092-7632
Phone: (866) 839-6979
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1104404 (TX)

Record details

NPI number1063245561
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedAugust 21, 2024
Last updated in NPPESAugust 21, 2024
Certification dateAugust 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Texas Luna Care Physical Therapy Llc — 267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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