Basic Information
Provider Information
NPI: 1326152943
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELSWOOD
FirstName: DAVID
MiddleName: SIDNEY
NamePrefix: MR.
NameSuffix:  
Credential: L.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1045 CENTRAL PARKWAY NORTH
Address2: SUITE 200
City: SAN ANTONIO
State: TX
PostalCode: 782325024
CountryCode: US
TelephoneNumber: 2105414500
FaxNumber: 2105414508
Practice Location
Address1: 3453 IH 35 N
Address2: SUITE 207B
City: SAN ANTONIO
State: TX
PostalCode: 782192333
CountryCode: US
TelephoneNumber: 2105680508
FaxNumber: 2105880510
Other Information
ProviderEnumerationDate: 08/19/2006
LastUpdateDate: 02/04/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1032746TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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