MEDICARE: HOLLY HAMBACHER YORK

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	:	1538775572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY HAMBACHER YORK

Provider Business Mailing Address
First Line	:	7505 N LOOP 1604 E STE 101
Second Line	:
City	:	LIVE OAK
State	:	TX
Zip	:	78233-2604
Country	:	US
Telephone Number	:	210-590-4000
Fax Number	:	210-590-4585

Provider Business Practice Location Address
First Line	:	1212 W PARMER LN STE G
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-4657
Country	:	US
Telephone Number	:	512-670-3238
Fax Number	:	512-670-3241

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

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	09/25/2023

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Directions to “ HOLLY HAMBACHER YORK ” Practice Location

Language	Start Address	Practice Location

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