Basic Information
| Provider Information | |||||||||
| NPI: | 1073074308 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS PHYSICAL THERAPY SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12508 JONES MALTSBERGER RD STE 110 | ||||||||
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| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782474215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885904002 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4100 EVERETT DR STE 130 | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786406332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127388510 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2019 | ||||||||
| LastUpdateDate: | 04/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | BENNETT | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | REGIONAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8306257310 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.