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NPI Code Detail

MEDICARE: ELIJAH MASON HENDRIX PT, DPT

MEDICARE: ELIJAH MASON HENDRIX PT, DPT
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
1225100000XPhysical Therapist1406873TX

General Provider Information

NPI Number : 1124912878
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIJAH MASON HENDRIX PT, DPT
Provider Business Mailing Address
First Line : 6900 ISABELLE DR
Second Line :
City : AUSTIN
State : TX
Zip : 78752-3108
Country : US
Telephone Number : 979-540-7593
Fax Number :
Provider Business Practice Location Address
First Line : 911 W 38TH ST STE 300
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1161
Country : US
Telephone Number : 512-439-1002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2025
Last Update Date : 04/06/2026

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