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NPI Code Detail

MEDICARE: GARY STEVEN HAMRE P.T.

MEDICARE: GARY STEVEN HAMRE P.T.
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
12251X0800XOrthopedic Physical Therapist1086478TX

General Provider Information

NPI Number : 1104913755
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY STEVEN HAMRE P.T.
Provider Business Mailing Address
First Line : 970 CORONADO BLVD
Second Line :
City : UNIVERSAL CITY
State : TX
Zip : 78148-3228
Country : US
Telephone Number : 210-659-2154
Fax Number : 210-659-2405
Provider Business Practice Location Address
First Line : 970 CORONADO BLVD
Second Line :
City : UNIVERSAL CITY
State : TX
Zip : 78148-3228
Country : US
Telephone Number : 210-659-2154
Fax Number : 210-659-2405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 10/29/2007

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