Provider Demographics
NPI:1629444617
Name:BJORK, ELISE (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ELISE
Middle Name:
Last Name:BJORK
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:BJORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8505 N CAPITAL OF TEXAS HWY
Mailing Address - Street 2:APT. 1010
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8447
Mailing Address - Country:US
Mailing Address - Phone:512-680-4884
Mailing Address - Fax:
Practice Address - Street 1:4300 WESTBANK DR. STE. 210
Practice Address - Street 2:
Practice Address - City:WESTLAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6771
Practice Address - Country:US
Practice Address - Phone:512-306-8071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1263016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist