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General NPI Number Information
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NPI Number | 1477090587
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Entity Type | Organization
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Legal Business Name | TEXAS PHYSICAL THERAPY SPECIALISTS, PC
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 960 GRUENE RD
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-3919
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Country | US
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Telephone | 830-302-2340
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Fax | 830-302-2341
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Provider Business Mailing Address
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Address Line | 12508 JONES MALTSBERGER RD 110
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City | SAN ANTONIO
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State | TX
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Zip | 78247-4214
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Country | US
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Telephone | 888-590-4002
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Fax | 210-590-4585
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Authorized Official
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Title or Position | CONTRACTING & CREDENTIALING MANAGER
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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 | 654940031
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License Number State | TX
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