Provider Demographics
NPI:1972640084
Name:THERAPY 180, LLC
Entity Type:Organization
Organization Name:THERAPY 180, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:210-561-5777
Mailing Address - Street 1:PO BOX 690871
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78269-0871
Mailing Address - Country:US
Mailing Address - Phone:210-561-5777
Mailing Address - Fax:210-561-5770
Practice Address - Street 1:12770 CIMARRON PATH
Practice Address - Street 2:SUITE 132
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3427
Practice Address - Country:US
Practice Address - Phone:210-561-5777
Practice Address - Fax:210-561-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65981000225100000X
TX225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty