Individual provider · Type 1 NPI

Evan Boullosa, LPTA

Physical Therapy Assistant · Fort Sam Houston, TX

NPI number 1780412585 Active

Practice location

3265 Koehler Rd Bldg 1385
Fort Sam Houston, TX 78234-7587

Call (210) 221-5033 Map

Mailing address

227 Dwyer Ave Apt 210
San Antonio, TX 78204-1238

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X2159129 (TX)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1780412585

Evan Boullosa, LPTA's National Provider Identifier is 1780412585, issued on Jul 23, 2024. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Fort Sam Houston, TX. The record was last updated on Jul 23, 2024.