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General NPI Number Information
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NPI Number | 1427741669
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Entity Type | Organization
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Legal Business Name | CORE PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 9822 POTRANCO RD STE 112
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City | SAN ANTONIO
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State | TX
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Zip | 78251-9608
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Country | US
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Telephone | 726-800-7227
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Fax | 726-800-7254
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Provider Business Mailing Address
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Address Line | 6825 HUEBNER RD UNIT 681418
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City | SAN ANTONIO
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State | TX
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Zip | 78268-6850
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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 | LEON GOUDEAU
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Credential |
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Telephone | 940-733-4375
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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 |
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License Number State |
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