MEDICARE: TEXAS PHYSICAL THERAPY SPECIALISTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1073074308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS PHYSICAL THERAPY SPECIALISTS

Provider Business Mailing Address
First Line	:	12508 JONES MALTSBERGER RD STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4215
Country	:	US
Telephone Number	:	888-590-4002
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 EVERETT DR STE 130
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-6332
Country	:	US
Telephone Number	:	512-738-8510
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL DIRECTOR
Name	:	ANDREW C. BENNETT
Credential	:
Telephone Number	:	830-625-7310

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	04/05/2019

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