MEDICARE: ALISHA ANN PONCE 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
1	225100000X	Physical Therapist	1233576	TX

General Provider Information

NPI Number	:	1316370570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISHA ANN PONCE PT, DPT

Provider Business Mailing Address
First Line	:	1965 POST RD STE 102
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5187
Country	:	US
Telephone Number	:	210-446-7424
Fax Number	:	210-503-0468

Provider Business Practice Location Address
First Line	:	1965 POST RD STE 102
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5187
Country	:	US
Telephone Number	:	210-446-7424
Fax Number	:	210-503-0468

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

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	03/04/2024

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