Healthcare Provider Details

I. General information

NPI: 1316184906
Provider Name (Legal Business Name): TEXAS PHYSICAL THERAPY SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2009
Last Update Date: 01/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3453 N IH 35 SUITE 211
SAN ANTONIO TX
78219-2333
US

IV. Provider business mailing address

8930 FOUR WINDS DR SUITE 109
SAN ANTONIO TX
78239-1970
US

V. Phone/Fax

Practice location:
  • Phone: 210-228-0215
  • Fax: 210-228-0223
Mailing address:
  • Phone: 888-590-4002
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number654940006
License Number StateTX

VIII. Authorized Official

Name: MR. ANDREW C BENNETT
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 830-625-7310