Healthcare Provider Details

I. General information

NPI: 1912104936
Provider Name (Legal Business Name): TEXAS PHYSICAL THERAPY SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 HUNTER RD SUITE 1104
SAN MARCOS TX
78666-5263
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 512-396-5122
  • Fax: 512-396-5123
Mailing address:
  • Phone: 888-590-4002
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number654940004
License Number StateTX

VIII. Authorized Official

Name: ANDREW BENNETT
Title or Position: PRESIDENT
Credential: DPT
Phone: 830-625-7310