Provider Demographics
NPI:1851590483
Name:TEXAS PHYSICAL THERAPY SPECIALISTS PC
Entity Type:Organization
Organization Name:TEXAS PHYSICAL THERAPY SPECIALISTS PC
Other - Org Name:TEXAS PHYSICAL THERAPY SPECIALISTS BULVERDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:830-625-7310
Mailing Address - Street 1:1324 COMMON ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3565
Mailing Address - Country:US
Mailing Address - Phone:830-625-7310
Mailing Address - Fax:830-625-8223
Practice Address - Street 1:184 CREEKSIDE PARK
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070
Practice Address - Country:US
Practice Address - Phone:830-625-7310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00372XMedicare ID - Type Unspecified