MEDICARE: MR. THOMAS C RICHTER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1046258	TX

General Provider Information

NPI Number	:	1043487853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS C RICHTER PT

Provider Business Mailing Address
First Line	:	6942 COUNTRY VIEW LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-2707
Country	:	US
Telephone Number	:	210-690-4075
Fax Number	:

Provider Business Practice Location Address
First Line	:	6942 COUNTRY VIEW LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-2707
Country	:	US
Telephone Number	:	210-690-4075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	05/12/2008

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