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General NPI Number Information
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NPI Number | 1063300499
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Entity Type | Organization
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Legal Business Name | MAZA MOVEMENT AND RECOVERY, LLC
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 391 LANDA ST STE 1202
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-7486
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Country | US
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Telephone | 210-315-1636
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Fax |
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Provider Business Mailing Address
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Address Line | 14922 ENCHANTED CASTLE
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City | SAN ANTONIO
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State | TX
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Zip | 78247-3052
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLAS JOSE MAZA
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Credential | PT, DPT
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Telephone | 210-315-1636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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