Provider Demographics
NPI:1417501982
Name:CONLIN, AUSTIN MICHAEL (PT)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:MICHAEL
Last Name:CONLIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 MARLINTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-0948
Mailing Address - Country:US
Mailing Address - Phone:210-412-1354
Mailing Address - Fax:
Practice Address - Street 1:7555 NW LOOP 410 STE 114
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2354
Practice Address - Country:US
Practice Address - Phone:210-520-8270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3124093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist