Provider Demographics
NPI:1417113028
Name:SAN ANTONIO CENTER FOR PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:SAN ANTONIO CENTER FOR PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEA
Authorized Official - Middle Name:E
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MTC
Authorized Official - Phone:210-316-5387
Mailing Address - Street 1:18518 HARDY OAK BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4759
Mailing Address - Country:US
Mailing Address - Phone:210-316-5387
Mailing Address - Fax:
Practice Address - Street 1:18518 HARDY OAK BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4759
Practice Address - Country:US
Practice Address - Phone:210-316-5387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-03
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX663440000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy