Healthcare Provider Details

I. General information

NPI: 1902163843
Provider Name (Legal Business Name): ASCENT PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2012
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2712 BEE CAVE RD #110
AUSTIN TX
78746-5676
US

IV. Provider business mailing address

2712 BEE CAVE RD #110
AUSTIN TX
78746-5676
US

V. Phone/Fax

Practice location:
  • Phone: 512-732-2220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number1232971
License Number StateTX

VIII. Authorized Official

Name: DR. ELIZABETH L. RECORD
Title or Position: OWNER
Credential: DPT
Phone: 512-732-2220