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NPI Code Detail

MEDICARE: HOLLY J HART P.T., D.P.T.

MEDICARE: HOLLY J HART P.T., D.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
1261QP2000XPhysical Therapy Clinic/Center1261647TX

General Provider Information

NPI Number : 1790152726
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY J HART P.T., D.P.T.
Provider Business Mailing Address
First Line : 13818 BENT RIDGE DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78249-1595
Country : US
Telephone Number : 832-287-6897
Fax Number :
Provider Business Practice Location Address
First Line : 18600 HARDY OAK BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-4206
Country : US
Telephone Number : 210-404-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2015
Last Update Date : 08/25/2015

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