Provider Demographics
NPI:1184333106
Name:MY PHYSICAL THERAPIST PLLC
Entity type:Organization
Organization Name:MY PHYSICAL THERAPIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DSC
Authorized Official - Phone:210-386-2133
Mailing Address - Street 1:4617 RED ROCK PASS
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1123
Mailing Address - Country:US
Mailing Address - Phone:210-386-2133
Mailing Address - Fax:
Practice Address - Street 1:4617 RED ROCK PASS
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1123
Practice Address - Country:US
Practice Address - Phone:210-386-2133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health