Provider Demographics
NPI:1891131843
Name:PT HOME SERVICES OF SAN ANTONIO, INC.
Entity Type:Organization
Organization Name:PT HOME SERVICES OF SAN ANTONIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-468-4747
Mailing Address - Street 1:444 EXECUTIVE CENTER BLVD
Mailing Address - Street 2:SUITE 148
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1058
Mailing Address - Country:US
Mailing Address - Phone:915-600-2796
Mailing Address - Fax:915-533-0722
Practice Address - Street 1:444 EXECUTIVE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1058
Practice Address - Country:US
Practice Address - Phone:915-600-2796
Practice Address - Fax:915-533-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013858251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health