Basic Information
| Provider Information | |||||||||
| NPI: | 1891173712 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS PHYSICAL THERAPY SPECIALISTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17325 BELL NORTH DR | ||||||||
| Address2: | SUITE 2-B | ||||||||
| City: | SCHERTZ | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781543368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885904002 | ||||||||
| FaxNumber: | 2105904585 | ||||||||
| Practice Location | |||||||||
| Address1: | 13740 W STATE HIGHWAY 29 | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | LIBERTY HILL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786426283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127786700 | ||||||||
| FaxNumber: | 5127786121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2015 | ||||||||
| LastUpdateDate: | 06/16/2016 | ||||||||
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| AuthorizedOfficialLastName: | BURRELL | ||||||||
| AuthorizedOfficialFirstName: | SHYLA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 8885904002 | ||||||||
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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.