Basic Information
Provider Information
NPI: 1447807839
EntityType: 2
ReplacementNPI:  
OrganizationName: TEXAS PHYSICAL THERAPY SPECIALISTS
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Mailing Information
Address1: 12508 JONES MALTSBERGER RD STE 110
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782474215
CountryCode: US
TelephoneNumber: 8885904002
FaxNumber: 2105904585
Practice Location
Address1: 101 MEDICAL PARKWAY
Address2: SUITE 110
City: LAKEWAY
State: TX
PostalCode: 78738
CountryCode: US
TelephoneNumber: 5128794343
FaxNumber: 5128794344
Other Information
ProviderEnumerationDate: 08/21/2019
LastUpdateDate: 08/21/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BENNETT
AuthorizedOfficialFirstName: ANDREW
AuthorizedOfficialMiddleName: C.
AuthorizedOfficialTitleorPosition: MEMBER/OWNER
AuthorizedOfficialTelephone: 8306257310
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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