MEDICARE: REPTD LLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1871423517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REPTD LLC

Provider Business Mailing Address
First Line	:	PO BOX 6415
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-0415
Country	:	US
Telephone Number	:	210-427-2920
Fax Number	:

Provider Business Practice Location Address
First Line	:	3233 N SAINT MARYS ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-3579
Country	:	US
Telephone Number	:	210-427-2920
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAM MCCRARY
Credential	:	LAT
Telephone Number	:	210-427-2920

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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