Provider Demographics
NPI:1598134157
Name:FORSYTHE, ERIN (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 PLEASANTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214-1306
Mailing Address - Country:US
Mailing Address - Phone:210-921-3800
Mailing Address - Fax:210-334-2851
Practice Address - Street 1:730 PLEASANTON RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214
Practice Address - Country:US
Practice Address - Phone:210-921-3800
Practice Address - Fax:210-334-2851
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20188225100000X
TX1270002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX508276YKQQMedicare PIN