Provider Demographics
NPI:1144913948
Name:COUVERETTE, FREDERICK MAURICE (PT, DPT)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:MAURICE
Last Name:COUVERETTE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E SONTERRA BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-5054
Mailing Address - Country:US
Mailing Address - Phone:210-828-7557
Mailing Address - Fax:210-892-8775
Practice Address - Street 1:150 E SONTERRA BLVD STE 305
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-5054
Practice Address - Country:US
Practice Address - Phone:210-828-7557
Practice Address - Fax:210-892-8775
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1377027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist