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Organization
WELLPOINT PHYSICAL THERAPY SERVICES, P.C.
Active
Organization
WELLPOINT PHYSICAL THERAPY SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARL HERMANN PT, PHD (PRESIDENT)
(979) 690-1999
Entity
Organization
Contact information
Practice address
4190 STATE HIGHWAY 6 S, COLLEGE STATION, TX 77845-8964
(979) 690-1999
(979) 690-1906
Mailing address
PO BOX 11165, COLLEGE STATION, TX 77842-1165
(979) 690-1999
(979) 690-1906
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1093607
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057JZ
BLUE CROSS BLUE SHIELD
TX
05
—
166736201
—
TX
Enumeration date
03/20/2007
Last updated
02/29/2012
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