Provider Demographics
NPI:1174801971
Name:ALL SCHERTZ-CIBOLO PHYSICAL THERAPY
Entity type:Organization
Organization Name:ALL SCHERTZ-CIBOLO PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-659-4333
Mailing Address - Street 1:17323 IH 35 N
Mailing Address - Street 2:STE. 107
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1277
Mailing Address - Country:US
Mailing Address - Phone:210-659-4333
Mailing Address - Fax:210-659-0809
Practice Address - Street 1:17323 IH 35 N
Practice Address - Street 2:STE. 107
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1277
Practice Address - Country:US
Practice Address - Phone:210-659-4333
Practice Address - Fax:210-659-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671030000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F7370Medicare PIN