Provider Demographics
NPI:1215936596
Name:SOUTH TEXAS PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:SOUTH TEXAS PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:INFANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-753-3660
Mailing Address - Street 1:6508 N BARTLETT AVE
Mailing Address - Street 2:STE A
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6445
Mailing Address - Country:US
Mailing Address - Phone:956-753-3660
Mailing Address - Fax:956-753-3670
Practice Address - Street 1:6508 N BARTLETT AVE
Practice Address - Street 2:STE A
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6445
Practice Address - Country:US
Practice Address - Phone:956-753-3660
Practice Address - Fax:956-753-3670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056653225100000X
TX104113225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00684WMedicare ID - Type Unspecified