Provider Demographics
NPI:1619977394
Name:SNOWDEN ORTHOPEDIC & OCCUPATIONAL REHABILITATION, P.C.
Entity type:Organization
Organization Name:SNOWDEN ORTHOPEDIC & OCCUPATIONAL REHABILITATION, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:IRVIN
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-615-8844
Mailing Address - Street 1:12758 CIMARRON PATH STE 126
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3498
Mailing Address - Country:US
Mailing Address - Phone:210-615-8844
Mailing Address - Fax:210-615-6959
Practice Address - Street 1:12758 CIMARRON PATH STE 126
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3498
Practice Address - Country:US
Practice Address - Phone:210-615-8844
Practice Address - Fax:210-615-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1022770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00156SMedicare UPIN
TXR69368Medicare UPIN