Provider Demographics
NPI:1093917833
Name:CATALYST PHYSICAL THERAPY, P.L.L.C
Entity Type:Organization
Organization Name:CATALYST PHYSICAL THERAPY, P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-308-5558
Mailing Address - Street 1:2210 NW MILITARY HWY
Mailing Address - Street 2:SUTIE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1815
Mailing Address - Country:US
Mailing Address - Phone:210-308-5558
Mailing Address - Fax:210-308-5557
Practice Address - Street 1:2210 NW MILITARY HWY
Practice Address - Street 2:SUTIE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1815
Practice Address - Country:US
Practice Address - Phone:210-308-5558
Practice Address - Fax:210-308-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6609700002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1917973Medicaid
TX9312107OtherAETNA
TX0077QAOtherBCBS
TX00Y796Medicare PIN