Provider Demographics
NPI:1114509833
Name:FORGED PHYSICAL THERAPY AND PERFORMANCE, PLLC
Entity type:Organization
Organization Name:FORGED PHYSICAL THERAPY AND PERFORMANCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:210-201-3209
Mailing Address - Street 1:5337 GLEN RIDGE DR STE 119
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5480
Mailing Address - Country:US
Mailing Address - Phone:210-201-3209
Mailing Address - Fax:210-866-0211
Practice Address - Street 1:5337 GLEN RIDGE DR STE 119
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5480
Practice Address - Country:US
Practice Address - Phone:210-201-3209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy