Provider Demographics
NPI:1346465762
Name:PHYSICAL THERAPY PROVIDERS, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:KEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEDIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-366-1733
Mailing Address - Street 1:800 ISOM , STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216
Mailing Address - Country:US
Mailing Address - Phone:210-366-1733
Mailing Address - Fax:
Practice Address - Street 1:8257 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3357
Practice Address - Country:US
Practice Address - Phone:210-593-0578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00776ZMedicare ID - Type UnspecifiedGROUP MEDICARE #