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NPI Code Detail

MEDICARE: ELIZABETH MARY KOELBEL PT, DPT

MEDICARE: ELIZABETH MARY KOELBEL 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 Therapist1227257TX

General Provider Information

NPI Number : 1578803060
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARY KOELBEL PT, DPT
Provider Business Mailing Address
First Line : 10555 CULEBRA RD
Second Line : SUITE 103
City : SAN ANTONIO
State : TX
Zip : 78251-3666
Country : US
Telephone Number : 210-888-6042
Fax Number : 210-888-6045
Provider Business Practice Location Address
First Line : 10555 CULEBRA RD
Second Line : SUITE 103
City : SAN ANTONIO
State : TX
Zip : 78251-3666
Country : US
Telephone Number : 210-888-6042
Fax Number : 210-888-6045
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2013
Last Update Date : 02/05/2015

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