Provider Demographics
NPI:1316184906
Name:TEXAS PHYSICAL THERAPY SPECIALISTS
Entity Type:Organization
Organization Name:TEXAS PHYSICAL THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-625-7310
Mailing Address - Street 1:8930 FOUR WINDS DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1970
Mailing Address - Country:US
Mailing Address - Phone:888-590-4002
Mailing Address - Fax:210-590-4585
Practice Address - Street 1:3453 N IH 35
Practice Address - Street 2:SUITE 211
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219-2333
Practice Address - Country:US
Practice Address - Phone:210-228-0215
Practice Address - Fax:210-228-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654940006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6131280001Medicare NSC
TX00372XMedicare PIN