Brett Michael Daniel

Individual provider Active NPI Geriatric Physical Therapist · China Spring, TX

NPI 1922597715 · NPPES record last updated May 7, 2018

Key facts

NPI
1922597715
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Physical Therapist 2251G0304X
License
1133320 (TX)
Practice address
2370 Garrett LN
China Spring, TX 76633-2722
Phone
(254) 744-4470
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6898 Woodway Dr
Waco, TX 76712-6158
Phone (254) 870-0044

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200511001605 TX Practitioner - Physical Therapist in Private Practice 6305274085 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1133320TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Aquatic and Physical Therapy LLC Physical Therapist Current
since Jan 23, 2020
Accepting new patients

Locations

6898 Woodway Dr
Woodway, TX 76712
Phone (254) 870-0044

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1133320 TX
Geriatric Physical Therapist 2251G0304X 1133320 TX Yes

Addresses

Primary practice location

2370 Garrett LN
China Spring, TX 76633-2722

Mailing address

2370 Garrett LN
China Spring, TX 76633-2722
Phone (254) 744-4470

Other providers in China Spring, TX

All providers in China Spring, TX · Geriatric Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.