Provider Demographics
NPI:1487402772
Name:MCDANIEL, BROOK BISHOP (DPT, PT)
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:BISHOP
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12952 BANDERA RD STE 107
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4733
Mailing Address - Country:US
Mailing Address - Phone:830-253-2101
Mailing Address - Fax:830-779-2056
Practice Address - Street 1:13857 US HIGHWAY 87 W STE 400
Practice Address - Street 2:
Practice Address - City:LA VERNIA
Practice Address - State:TX
Practice Address - Zip Code:78121-5921
Practice Address - Country:US
Practice Address - Phone:830-253-2101
Practice Address - Fax:830-779-2056
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1397367225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist