Healthcare Provider Details

I. General information

NPI: 1902233273
Provider Name (Legal Business Name): BEXAR PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 BRIGGS ST 245
SAN ANTONIO TX
78224-1271
US

IV. Provider business mailing address

88 BRIGGS ST 245
SAN ANTONIO TX
78224-1271
US

V. Phone/Fax

Practice location:
  • Phone: 830-719-3456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number9154
License Number StateCO

VIII. Authorized Official

Name: SONIA HERNANDEZ
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 830-719-3456