Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tarek Ibrahim

Individual provider Physical Therapist · NPI 1790449536

Tarek Ibrahim is a Physical Therapist in Private Practice in Southlake, Texas. Qualified in 1981, 45 years ago. Practices with Texas Luna Care Physical Therapy LLC, a 267-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
45
Licensed in
TX
In the registry since
2021
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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 1086569 (TX)

Record details

NPI number1790449536
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 27, 2021
Last updated in NPPESOctober 27, 2021
Certification dateOctober 27, 2021
Mailing address180 State St Ste 225, Southlake, TX 76092-7632

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1981 (45 years in practice)
Group practice Texas Luna Care Physical Therapy Llc — 267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Southlake