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General NPI Number Information
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NPI Number | 1225380025
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Entity Type | Organization
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Legal Business Name | TEXAS PHYSICAL THERAPY SPECIALISTS - JOURDANTON
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 1400 HIGHWAY 97 E SUITE A
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City | JOURDANTON
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State | TX
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Zip | 78026-1602
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Country | US
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Telephone | 830-769-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 17325 BELL NORTH DR SUITE 2-B
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City | SCHERTZ
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State | TX
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Zip | 78154-3368
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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 | CREDENTIALING COORDINATOR
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Name | SHYLA BURRELL
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Credential |
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Telephone | 888-590-4002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 654940008
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License Number State |
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