Individual provider Active NPI

Marc Pictrowski, PT

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1073783296
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1137461 Issued in TX
Practice address
6655 First Park Ten Blvd Ste 230
San Antonio, TX 78213-4304
Phone
(210) 733-0524
Fax
(210) 733-0411
NPI assigned
Mar 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1137461 TX Primary

Addresses

Primary practice location

6655 First Park Ten Blvd Ste 230
San Antonio, TX 78213-4304

Mailing address

6655 First Park Ten Blvd Ste 230
San Antonio, TX 78213-4304
Phone (210) 733-0524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1137461TXMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1073783296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 FIRST PARK TEN BLVD STE 230",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134304",
            "telephone_number": "210-733-0524",
            "fax_number": "210-733-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 FIRST PARK TEN BLVD STE 230",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134304",
            "telephone_number": "210-733-0524",
            "fax_number": "210-733-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICTROWSKI",
        "first_name": "MARC",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1137461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.