MEDICARE: SAMUEL J HERRERA 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
1	225100000X	Physical Therapist	1400422	TX

General Provider Information

NPI Number	:	1306796479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL J HERRERA DPT

Provider Business Mailing Address
First Line	:	PO BOX 932184
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-2184
Country	:	US
Telephone Number	:	512-213-6261
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 KOHLERS XING STE 550
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-3302
Country	:	US
Telephone Number	:	512-213-6261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ SAMUEL J HERRERA DPT” Practice Location

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