Provider Demographics
NPI:1922188689
Name:STRATTON, BRIK ALDEN (PT, MSPT)
Entity Type:Individual
Prefix:
First Name:BRIK
Middle Name:ALDEN
Last Name:STRATTON
Suffix:
Gender:M
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 W SUNSET RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1769
Mailing Address - Country:US
Mailing Address - Phone:210-828-7557
Mailing Address - Fax:210-828-7756
Practice Address - Street 1:414 W SUNSET RD STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1769
Practice Address - Country:US
Practice Address - Phone:210-828-7557
Practice Address - Fax:210-828-7756
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83603EMedicare ID - Type UnspecifiedMEDICARE
TXP35492Medicare UPIN