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General NPI Number Information
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NPI Number | 1992245344
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Entity Type | Organization
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Legal Business Name | CENTRAL TEXAS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 03/05/2017
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Last Update Date | 03/05/2017
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Provider Practice Location Address
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Address Line | 3809 S 2ND ST STE B100
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City | AUSTIN
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State | TX
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Zip | 78704-7015
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Country | US
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Telephone | 512-447-9675
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Fax | 512-428-9675
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Provider Business Mailing Address
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Address Line | 3809 S 2ND ST STE B100
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City | AUSTIN
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State | TX
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Zip | 78704-7015
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Country | US
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Telephone | 512-447-9675
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Fax | 512-428-9675
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD LEE WRIGHT
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Credential |
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Telephone | 512-447-9675
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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 | 671120000
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License Number State | TX
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