Provider Demographics
NPI:1841209418
Name:PRATT, GILBERT ANDREW JR (LPT)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:ANDREW
Last Name:PRATT
Suffix:JR
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 120277
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-9477
Mailing Address - Country:US
Mailing Address - Phone:210-710-2909
Mailing Address - Fax:
Practice Address - Street 1:7333 BARLITE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1320
Practice Address - Country:US
Practice Address - Phone:210-924-3040
Practice Address - Fax:210-924-3889
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1038107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1038107OtherPHYSICAL THERAPY LICENSE