Provider Demographics
NPI:1215960836
Name:PHYSICAL THERAPY SPECIALTY CLINIC, PC
Entity type:Organization
Organization Name:PHYSICAL THERAPY SPECIALTY CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:BASLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:512-219-5377
Mailing Address - Street 1:12741 RESEARCH BLVD
Mailing Address - Street 2:SUITE 505-B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4388
Mailing Address - Country:US
Mailing Address - Phone:512-219-5377
Mailing Address - Fax:512-219-5376
Practice Address - Street 1:12741 RESEARCH BLVD
Practice Address - Street 2:SUITE 505-B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4388
Practice Address - Country:US
Practice Address - Phone:512-219-5377
Practice Address - Fax:512-219-5376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10514152251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty