NPI Code Details Logo

NPI 1699584656

NPI 1699584656 : RESILIENCE PHYSICAL THERAPY PLLC : BOERNE, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1699584656
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    RESILIENCE PHYSICAL THERAPY PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/04/2025
-----------------------------------------------------
    Last Update Date     |    03/30/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    7234 CIMARRON LK 
-----------------------------------------------------
    City                 |    BOERNE
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78015-4357
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    575-635-1668
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    7234 CIMARRON LK 
-----------------------------------------------------
    City                 |    BOERNE
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78015-4357
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    575-635-1668
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/PHYSICAL THERAPIST
-----------------------------------------------------
    Name                 |     EVAN  MCCANN 
-----------------------------------------------------
    Credential           |    DPT
-----------------------------------------------------
    Telephone            |    575-635-1668
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.