Organization Active NPI

Wells Physical Therapy of Boerne, P.L.L.C.

  • Orthopedic Physical Therapist
  • Boerne, TX
National Provider Identifier
1619912383
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
WELLS PHYSICAL THERAPY OF BOERNE, P.L.L.C.
Practice address
34910 Ih 10 W
Suite 401
Boerne, TX 78006-9229
Phone
(830) 816-2611
Fax
(830) 816-2688
NPI assigned
Jun 18, 2006
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Brent L. Wells, P.T.
Title
Owner
Phone
(830) 816-2611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X TX Primary

Addresses

Primary practice location

34910 Ih 10 W
Suite 401
Boerne, TX 78006-9229

Mailing address

PO Box 1468
Boerne, TX 78006-1468
Phone (830) 816-2611

Other identifiers 1

IdentifierTypeStateIssuer
179987601MedicaidTX

National Provider Directory

National Provider Directory

Locations

34910 Interstate 10 W
Ste 401
Boerne, TX 78006
Phone (830) 816-2600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1619912383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1468",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061468",
            "telephone_number": "830-816-2611",
            "fax_number": "830-816-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34910 IH 10 W",
            "address_2": "SUITE 401",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780069229",
            "telephone_number": "830-816-2611",
            "fax_number": "830-816-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS PHYSICAL THERAPY OF BOERNE, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-816-2611",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179987601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.