Individual provider Active NPI

Mark L Heniser, PT

  • Physical Therapist
  • Fort Sam Houston, TX
National Provider Identifier
1629049739
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1159200 Issued in TX
Practice address
3851 Roger Brooke Dr
Brooke Army Medical Center Amputee Physical Therapy
Fort Sam Houston, TX 78234-4501
Phone
(210) 916-5048
Fax
(210) 916-4074
NPI assigned
Jan 27, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501011867 MI
Physical Therapist 225100000X 14873 CA
Physical Therapist 225100000X 1159200 TX Primary

Addresses

Primary practice location

3851 Roger Brooke Dr
Brooke Army Medical Center Amputee Physical Therapy
Fort Sam Houston, TX 78234-4501

Mailing address

964 Persian GDN
San Antonio, TX 78258-6658
Phone (210) 916-5048

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
14873CAMDPhysical Therapist
5501011867MIMDPhysical Therapist
1159200TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629049739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 PERSIAN GDN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782586658",
            "telephone_number": "210-916-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 ROGER BROOKE DR",
            "address_2": "BROOKE ARMY MEDICAL CENTER AMPUTEE PHYSICAL THERAPY",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344501",
            "telephone_number": "210-916-5048",
            "fax_number": "210-916-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENISER",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501011867",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "14873",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1159200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.