Provider Demographics
NPI:1114157237
Name:NEW BRAUNFELS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:NEW BRAUNFELS PHYSICAL THERAPY, INC.
Other - Org Name:COMPREHENSIVE CHIROPRACTIC & PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-545-1810
Mailing Address - Street 1:930 PROTON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4232
Mailing Address - Country:US
Mailing Address - Phone:210-545-1810
Mailing Address - Fax:210-545-1811
Practice Address - Street 1:930 PROTON RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4232
Practice Address - Country:US
Practice Address - Phone:210-545-1810
Practice Address - Fax:210-545-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty