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General NPI Number Information
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NPI Number | 1013126838
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Entity Type | Organization
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Legal Business Name | PT HOME SERVICES OF SAN ANTONIO, INC.
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/25/2017
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Provider Practice Location Address
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Address Line | 40 NE LOOP 410 #640
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5828
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Country | US
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Telephone | 210-342-2667
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Fax | 210-340-2416
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Provider Business Mailing Address
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Address Line | 40 N E LOOP 410 SUITE 640
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5827
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Country | US
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Telephone | 718-468-4747
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Fax | 718-264-5834
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Authorized Official
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Title or Position | BOARD MEMBER/PRESIDENT
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Name | ROBERT MARX
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Credential |
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Telephone | 718-468-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 003402
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License Number State | TX
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