Provider Demographics
NPI:1275679441
Name:BIEDIGER, DAVID SCOTT (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SCOTT
Last Name:BIEDIGER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593349
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0217
Mailing Address - Country:US
Mailing Address - Phone:210-213-4444
Mailing Address - Fax:830-980-6303
Practice Address - Street 1:2696 S COLORADO BLVD
Practice Address - Street 2:STE. 240
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5945
Practice Address - Country:US
Practice Address - Phone:210-213-4444
Practice Address - Fax:830-980-6303
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078228225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPTL0014575OtherCO PT LICENSE
TX1078228OtherPT LICENSE NUMBER
TX182089601Medicaid
TX8F1674Medicare PIN