1447854989 NPI number — NEW BRAUNFELS MOBILE PHYSICAL THERAPY PLLC

Table of content: (NPI 1447854989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447854989 NPI number — NEW BRAUNFELS MOBILE PHYSICAL THERAPY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BRAUNFELS MOBILE PHYSICAL THERAPY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447854989
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1659 STATE HWY 46 W
Provider Second Line Business Mailing Address:
STE 115. BOX# 486
Provider Business Mailing Address City Name:
NEW BRAUNFELS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-837-2771
Provider Business Mailing Address Fax Number:
830-310-7901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1165 NUTMEG TRAIL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BRAUNFELS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-837-2777
Provider Business Practice Location Address Fax Number:
830-310-7901
Provider Enumeration Date:
11/25/2020

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
830-837-2777

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4205155 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com