MEDICARE: AGILITAS USA INC

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	:	1992407720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGILITAS USA INC

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	12991 POTRANCO RD STE 112
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-7105
Country	:	US
Telephone Number	:	726-223-4999
Fax Number	:	210-787-1247

Authorized Official
Title or Position	:	CFO
Name	:	THOMAS BRYAN BARGANIER
Credential	:
Telephone Number	:	205-536-7602

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	06/02/2023

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Directions to “AGILITAS USA INC ” Practice Location

Language	Start Address	Practice Location

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