Healthcare Provider Details

I. General information

NPI: 1992700215
Provider Name (Legal Business Name): BENJAMIN TODD MORGAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10526 W PARMER LN SUITE 403
AUSTIN TX
78717-5056
US

IV. Provider business mailing address

17325 BELL NORTH DR SUITE 2-B
SCHERTZ TX
78154-3368
US

V. Phone/Fax

Practice location:
  • Phone: 512-900-3302
  • Fax: 512-900-3321
Mailing address:
  • Phone: 888-590-4002
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1157667
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: