Provider Demographics
NPI:1619977394
Name:SNOWDEN ORTHOPEDIC & OCCUPATIONAL REHABILITATION, P.C.
Entity Type:Organization
Organization Name:SNOWDEN ORTHOPEDIC & OCCUPATIONAL REHABILITATION, P.C.
Other - Org Name:BPT, THERAPY SERVICES, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:IRVIN
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-615-8844
Mailing Address - Street 1:2414 BABCOCK RD
Mailing Address - Street 2:STE. 112
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4870
Mailing Address - Country:US
Mailing Address - Phone:210-615-8844
Mailing Address - Fax:210-615-6959
Practice Address - Street 1:2414 BABCOCK RD
Practice Address - Street 2:STE. 112
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4870
Practice Address - Country:US
Practice Address - Phone:210-615-8844
Practice Address - Fax:210-615-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1022770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00156SMedicare UPIN
TXR69368Medicare UPIN