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NPI Code Detail

MEDICARE: PATRICK RYAN LABRODE DPT

MEDICARE: PATRICK RYAN LABRODE 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 Therapist

General Provider Information

NPI Number : 1790331551
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK RYAN LABRODE DPT
Provider Business Mailing Address
First Line : 12508 JONES MALTSBERGER RD STE 110
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-4215
Country : US
Telephone Number : 210-590-4000
Fax Number : 210-590-4585
Provider Business Practice Location Address
First Line : 1789 S BAGDAD RD STE 102
Second Line :
City : LEANDER
State : TX
Zip : 78641-3795
Country : US
Telephone Number : 512-337-8970
Fax Number : 512-337-8971
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2019
Last Update Date : 08/16/2019

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