Provider Demographics
NPI:1942691670
Name:ELLIOTT, JOSEPH T (DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:DPT
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
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1756
Mailing Address - Country:US
Mailing Address - Phone:210-828-7557
Mailing Address - Fax:210-828-7756
Practice Address - Street 1:414 W SUNSET RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1756
Practice Address - Country:US
Practice Address - Phone:210-828-7557
Practice Address - Fax:210-828-7756
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1191758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist