Provider Demographics
NPI:1104103852
Name:FOUNDATION PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:FOUNDATION PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPEAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-698-6333
Mailing Address - Street 1:23127 IH 10 W
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-2506
Mailing Address - Country:US
Mailing Address - Phone:210-698-6333
Mailing Address - Fax:210-698-6332
Practice Address - Street 1:23127 IH 10 WEST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-2506
Practice Address - Country:US
Practice Address - Phone:210-698-6333
Practice Address - Fax:210-698-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy