MEDICARE: JAN C COMMER DPT, 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	1137636	TX

General Provider Information

NPI Number	:	1235460809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAN C COMMER DPT, PT

Provider Business Mailing Address
First Line	:	12952 BANDERA RD STE 107
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-4733
Country	:	US
Telephone Number	:	210-314-1402
Fax Number	:	210-530-1309

Provider Business Practice Location Address
First Line	:	21727 W INTERSTATE 10 STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-2108
Country	:	US
Telephone Number	:	210-314-1402
Fax Number	:	210-530-1309

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

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	05/27/2025

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