Healthcare Provider Details

I. General information

NPI: 1497525281
Provider Name (Legal Business Name): BTRM-BC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 LEANDER RD
GEORGETOWN TX
78628-8801
US

IV. Provider business mailing address

PO BOX 171078
AUSTIN TX
78717-0040
US

V. Phone/Fax

Practice location:
  • Phone: 512-493-4473
  • Fax: 512-777-5042
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. ERNIE BELTZ
Title or Position: MANAGER
Credential:
Phone: 512-773-9182