MEDICARE: MR. DON H ANTIS 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	1031011	TX

General Provider Information

NPI Number	:	1932166840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DON H ANTIS PT

Provider Business Mailing Address
First Line	:	1200 RICHLAND DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710
Country	:	US
Telephone Number	:	254-772-0118
Fax Number	:	254-772-3883

Provider Business Practice Location Address
First Line	:	1200 RICHLAND DR
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710
Country	:	US
Telephone Number	:	254-772-0118
Fax Number	:	254-772-3883

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	03/08/2026

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