Provider Demographics
NPI:1427155183
Name:KINETICS PHYSICAL THERAPY LTD
Entity type:Organization
Organization Name:KINETICS PHYSICAL THERAPY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-632-7562
Mailing Address - Street 1:66 GRUENE PARK DR
Mailing Address - Street 2:114
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2460
Mailing Address - Country:US
Mailing Address - Phone:830-626-1166
Mailing Address - Fax:830-626-1167
Practice Address - Street 1:66 GRUENE PARK DR
Practice Address - Street 2:SUITE 114
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2460
Practice Address - Country:US
Practice Address - Phone:830-626-1166
Practice Address - Fax:830-626-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X888Medicare PIN