Dillon Scot Konvicka
Individual provider Active NPI Physical Therapy Assistant · Hallettsville, TX
NPI 1922587534 · NPPES record last updated Aug 14, 2018
Key facts
- NPI
- 1922587534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2068048 (TX)
- Practice address
- 106 Kahn St
Hallettsville, TX 77964-2177 - Phone
- (361) 798-3606
- NPI assigned
- Aug 14, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2068048 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2068048 | TX | Yes |
Addresses
Primary practice location
106 Kahn St
Hallettsville, TX 77964-2177
Mailing address
1004 Lakeside Dr
Yoakum, TX 77995-4703
Other providers in Hallettsville, TX
- Ruth C Johnson
- Kristi Kaiser
- Traci Lee Kaiser
- Cheryl Lynnette Kalmus
- Angela Kaye King
- Erik Wade Konvicka
- Susan L Kraemer
- Forrest Timothy Kroschel
- Amanda Lee Kurtz
- Lauren Kelly Kutac
All providers in Hallettsville, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.