Provider Demographics
NPI:1467254169
Name:JEM PHYSICAL THERAPY & SPORTS MEDICINE, PLLC
Entity type:Organization
Organization Name:JEM PHYSICAL THERAPY & SPORTS MEDICINE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:361-522-3239
Mailing Address - Street 1:1418 BREWERTON
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4233
Mailing Address - Country:US
Mailing Address - Phone:361-522-3239
Mailing Address - Fax:
Practice Address - Street 1:5462 ROGERS RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3631
Practice Address - Country:US
Practice Address - Phone:361-522-3239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty