MEDICARE: JACOB ANTHONY WETZ 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	1402045	TX

General Provider Information

NPI Number	:	1528858339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB ANTHONY WETZ DPT

Provider Business Mailing Address
First Line	:	633 DIAMOND SHLS
Second Line	:
City	:	CIBOLO
State	:	TX
Zip	:	78108-0359
Country	:	US
Telephone Number	:	830-832-2322
Fax Number	:

Provider Business Practice Location Address
First Line	:	11503 JONES MALTSBERGER RD STE 1101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-2630
Country	:	US
Telephone Number	:	210-890-2411
Fax Number	:

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

Provider Enumeration Date	:	05/07/2025
Last Update Date	:	05/09/2025

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