Provider Demographics
NPI:1457463564
Name:GREATHOUSE, DAVID GUY (PT, PHD, ECS, FAPTA)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GUY
Last Name:GREATHOUSE
Suffix:
Gender:M
Credentials:PT, PHD, ECS, FAPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 CRYSTAL PATH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3663
Mailing Address - Country:US
Mailing Address - Phone:210-402-3727
Mailing Address - Fax:
Practice Address - Street 1:1324 COMMON ST
Practice Address - Street 2:SUITE 307
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3565
Practice Address - Country:US
Practice Address - Phone:830-625-7310
Practice Address - Fax:830-625-3228
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11620212251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G0088Medicare ID - Type UnspecifiedPHYSICAL THERAPIST