MEDICARE: BULVERDE REHABILITATION & WELLNESS

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0036EF	OTHER	TX	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1649316746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULVERDE REHABILITATION & WELLNESS

Provider Business Mailing Address
First Line	:	21200 STATE HIGHWAY 46 W
Second Line	:
City	:	SPRING BRANCH
State	:	TX
Zip	:	78070-6793
Country	:	US
Telephone Number	:	830-980-4055
Fax Number	:	830-438-4085

Provider Business Practice Location Address
First Line	:	21200 STATE HIGHWAY 46 W
Second Line	:
City	:	SPRING BRANCH
State	:	TX
Zip	:	78070-6793
Country	:	US
Telephone Number	:	830-980-4055
Fax Number	:	830-438-4085

Authorized Official
Title or Position	:	MEMBER
Name	:	DARLENE MCGILL
Credential	:
Telephone Number	:	830-980-4055

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	02/24/2021

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Directions to “BULVERDE REHABILITATION & WELLNESS ” Practice Location

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