Provider Demographics
NPI:1124543871
Name:PHYSICAL THERAPY & FELDENKRAIS AUSTIN PC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY & FELDENKRAIS AUSTIN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THAIS
Authorized Official - Middle Name:BICALHO
Authorized Official - Last Name:SILVA-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, GCFP
Authorized Official - Phone:347-413-0052
Mailing Address - Street 1:7901 TARANTO DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-7440
Mailing Address - Country:US
Mailing Address - Phone:347-413-0052
Mailing Address - Fax:
Practice Address - Street 1:8133 MESA DR STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy