Provider Demographics
NPI:1164957684
Name:STRATTON PHYSICAL THERAPY
Entity Type:Organization
Organization Name:STRATTON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-612-7952
Mailing Address - Street 1:818 KNIGHTS CROSS DR
Mailing Address - Street 2:SUITE #5107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2982
Mailing Address - Country:US
Mailing Address - Phone:210-612-7952
Mailing Address - Fax:855-492-1012
Practice Address - Street 1:818 KNIGHTS CROSS DR
Practice Address - Street 2:SUITE #5107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-2982
Practice Address - Country:US
Practice Address - Phone:210-612-7952
Practice Address - Fax:855-492-1012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1030005174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX369496OtherOPT-OUT OF MEDICARE, OUT OF NETWORK PROVIDER