Healthcare Provider Details

I. General information

NPI: 1063825545
Provider Name (Legal Business Name): JOSHUA TROCK PT,DPT,RVT,CLT,CEWS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18831 MEISNER DR
SAN ANTONIO TX
78258-4240
US

IV. Provider business mailing address

18330 APACHE SPRINGS DR
SAN ANTONIO TX
78259-3603
US

V. Phone/Fax

Practice location:
  • Phone: 210-622-8000
  • Fax: 210-625-5151
Mailing address:
  • Phone: 210-249-8420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1207956
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: