MEDICARE: PSC FYZ DEZ, LLC

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

General Provider Information

NPI Number	:	1073401733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSC FYZ DEZ, LLC

Provider Business Mailing Address
First Line	:	6222 DE ZAVALA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6222 DE ZAVALA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2274
Country	:	US
Telephone Number	:	210-864-3174
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RYAN CINK
Credential	:
Telephone Number	:	215-422-2196

Provider Enumeration Date	:	06/24/2025
Last Update Date	:	06/24/2025

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