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NPI Code Detail

MEDICARE: MR. JEFFREY GOLAY WISSEL-LITTMANN PT

MEDICARE: MR. JEFFREY GOLAY WISSEL-LITTMANN PT
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 Therapist1077675TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11077675OTHERTXTEXAS PT LICENSE

General Provider Information

NPI Number : 1982757936
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY GOLAY WISSEL-LITTMANN PT
Provider Business Mailing Address
First Line : PO BOX 700688
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78270-0688
Country : US
Telephone Number : 210-318-3007
Fax Number : 210-468-0682
Provider Business Practice Location Address
First Line : 111 TOWER DR BLDG 1
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-3625
Country : US
Telephone Number : 800-404-6050
Fax Number : 866-313-3397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2007
Last Update Date : 04/12/2023

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