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General NPI Number Information
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NPI Number | 1790752418
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Entity Type | Individual
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Provider Name | THOMAS IRVIN WASHINGTON PT, M.B.A., ATC
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Gender | Male
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 12758 CIMARRON PATH STE 126
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3498
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Country | US
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Telephone | 210-615-8844
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Fax | 210-615-6959
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Provider Business Mailing Address
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Address Line | 12758 CIMARRON PATH STE 126
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City | SAN ANTONIO
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State | TX
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Zip | 78249-3498
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Country | US
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Telephone | 210-615-8844
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Fax | 210-615-6959
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1022770
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License Number State | TX
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