Provider Demographics
NPI:1194884965
Name:THERAPY 180
Entity type:Organization
Organization Name:THERAPY 180
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:SR
Authorized Official - Credentials:OTR
Authorized Official - Phone:210-394-0649
Mailing Address - Street 1:12770 CIMARRON PATH STE 132
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3416
Mailing Address - Country:US
Mailing Address - Phone:210-561-5777
Mailing Address - Fax:210-561-5770
Practice Address - Street 1:12770 CIMARRON PATH STE 132
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3416
Practice Address - Country:US
Practice Address - Phone:210-561-5777
Practice Address - Fax:210-561-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108049225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty