Provider Demographics
NPI:1972512663
Name:HARTMAN, JAMES R (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14220 NORTHBROOK
Mailing Address - Street 2:STE 700
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-822-8807
Mailing Address - Fax:210-822-8863
Practice Address - Street 1:540 MADISON OAK
Practice Address - Street 2:STE 360
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-545-4006
Practice Address - Fax:210-545-4096
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037026401Medicaid
TX80440TOtherBLUE CROSS BLUE SHIELD
TX0039869OtherBLUE LINK NO.
TX0370264-01Medicaid
TX037026401Medicaid