=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710619812
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ECHO PHYSICAL THERAPY AND ATHLETICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2022
-----------------------------------------------------
Last Update Date | 06/28/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 787 MAXIMINO RIDGE RD
-----------------------------------------------------
City | BULVERDE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78163-2542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-667-3875
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 787 MAXIMINO RIDGE RD
-----------------------------------------------------
City | BULVERDE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78163-2542
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-667-3875
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST/CO-OWNER
-----------------------------------------------------
Name | ROBERT CRAIG AKIN
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 210-667-3875
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------