Healthcare Provider Details

I. General information

NPI: 1356452411
Provider Name (Legal Business Name): TEXAS PHYSICAL THERAPY SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 WONDER WORLD DR SUITE 100
SAN MARCOS TX
78666-7546
US

IV. Provider business mailing address

1305 WONDER WORLD DR SUITE 100
SAN MARCOS TX
78666-7546
US

V. Phone/Fax

Practice location:
  • Phone: 512-878-2835
  • Fax: 512-878-2858
Mailing address:
  • Phone: 512-878-2835
  • Fax: 512-878-2858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ANDREW C. BENNETT
Title or Position: PRESIDENT
Credential: D.P.T.
Phone: 830-625-7310