Provider Demographics
NPI:1184699902
Name:BAIRNSFATHER, HERBERT LEE JR (PT, FAAOMPT)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:LEE
Last Name:BAIRNSFATHER
Suffix:JR
Gender:M
Credentials:PT, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 GOLDEN QUAIL
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1540
Mailing Address - Country:US
Mailing Address - Phone:210-421-7336
Mailing Address - Fax:
Practice Address - Street 1:4910 GOLDEN QUAIL
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1540
Practice Address - Country:US
Practice Address - Phone:210-421-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1162883225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J1719Medicare PIN