Healthcare Provider Details

I. General information

NPI: 1124596937
Provider Name (Legal Business Name): JONATHAN LOSCH PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2018
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20835 US HIGHWAY 281 N STE 508
SAN ANTONIO TX
78258-7599
US

IV. Provider business mailing address

12508 JONES MALTSBERGER RD STE 110
SAN ANTONIO TX
78247-4215
US

V. Phone/Fax

Practice location:
  • Phone: 210-998-6443
  • Fax: 210-998-6444
Mailing address:
  • Phone: 210-590-4000
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number295837
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1323516
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: