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NPI Code Detail

MEDICARE: PHYSICAL THERAPY ASSOCIATES

MEDICARE: PHYSICAL THERAPY ASSOCIATES
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
1174400000XSpecialist640210000TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
185643TOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1659547107
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICAL THERAPY ASSOCIATES
Provider Business Mailing Address
First Line : 127 MEDICAL PARK LN
Second Line :
City : HUNTSVILLE
State : TX
Zip : 77340-4972
Country : US
Telephone Number : 936-294-0283
Fax Number : 936-294-9878
Provider Business Practice Location Address
First Line : 127 MEDICAL PARK LN
Second Line :
City : HUNTSVILLE
State : TX
Zip : 77340-4972
Country : US
Telephone Number : 936-294-0283
Fax Number : 936-294-9878
Authorized Official
Title or Position : OFFICE MANAGER
Name : DIANE L WILLIAMS
Credential :
Telephone Number : 936-294-0283
Provider Enumeration Date : 05/05/2008
Last Update Date : 05/22/2008

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Directions to “PHYSICAL THERAPY ASSOCIATES ” Practice Location

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