Provider Demographics
NPI:1851767008
Name:NASCHKE, STACY R (DPT)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:R
Last Name:NASCHKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:R
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2140 BABCOCK RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4400
Mailing Address - Country:US
Mailing Address - Phone:210-614-7953
Mailing Address - Fax:210-614-4190
Practice Address - Street 1:3110 NOGALITOS STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78225-2338
Practice Address - Country:US
Practice Address - Phone:210-534-7953
Practice Address - Fax:210-534-6695
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1263580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist