South Texas Sports Medicine Inc
Organization Active NPI Physical Therapy Clinic/Center · Fulton, TX
NPI 1083933097 · NPPES record last updated Mar 23, 2026
Key facts
- NPI
- 1083933097
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 604380002 (TX)
- Legal business name
- SOUTH TEXAS SPORTS MEDICINE INC
- Practice address
- 1007 FM 3036
Fulton, TX 78358 - Phone
- (361) 729-8668
- NPI assigned
- Jun 1, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTH TEXAS SPORTS MEDICINE INC
Authorized official
- Name
- Donald Ray Zylks, PHD
- Title
- President
- Phone
- (361) 728-4288
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 2
Practitioners 4
-
Jed S. McNally, PHYSICAL THERAPIST
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250508003010 | TX | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3072644665 |
Receives reassigned benefits from 3 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Corpus Christi, TX; Fulton, TX; Portland, TX |
National Provider Directory
- Part of
- South Texas Sports Medicine Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 604380002 | TX | Yes |
Addresses
Primary practice location
1007 FM 3036
Fulton, TX 78358
Mailing address
5530 Lipes Blvd
Corpus Christi, TX 78413
Phone (361) 993-9494
Other providers in Fulton, TX
All providers in Fulton, TX · Physical Therapy Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.