Provider Demographics
NPI:1093766537
Name:BRETT CARPENTER PT, PLLC
Entity Type:Organization
Organization Name:BRETT CARPENTER PT, PLLC
Other - Org Name:THERAPY SOLUTIONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALTOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-944-4399
Mailing Address - Street 1:3126 APPALOOSA CR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901
Mailing Address - Country:US
Mailing Address - Phone:325-944-4399
Mailing Address - Fax:325-944-4556
Practice Address - Street 1:3126 APPALOOSA CR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901
Practice Address - Country:US
Practice Address - Phone:325-944-4399
Practice Address - Fax:325-944-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX28JBOtherGRP BLUE CROSS BLUE SHIEL
TX00876UMedicare ID - Type UnspecifiedGROUP