Provider Demographics
NPI:1659520203
Name:HAMMERLE, MATT HUGHES (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MATT
Middle Name:HUGHES
Last Name:HAMMERLE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 LAKEPARK DR
Mailing Address - Street 2:
Mailing Address - City:LAKEHILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78063-6211
Mailing Address - Country:US
Mailing Address - Phone:210-316-5486
Mailing Address - Fax:
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE QD (CREDS)
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-8693
Practice Address - Fax:210-916-6679
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1086460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist