Organization
EAGLE PASS THERAPY CLINIC PC
Active
Other names
Back to Action
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT ALAN TICE (DIRECTOR)
(956) 428-8951
Entity
Organization
Contact information
Practice address
1000 CROWN RIDGE BLVD, SUITE C, EAGLE PASS, TX 78852
(830) 757-2497
(830) 757-0489
Mailing address
PO BOX 532127, HARLINGEN, TX 78553
(956) 428-8951
(956) 428-0232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177682501
—
TX
01
—
86MR
BCBS
—
Enumeration date
07/31/2006
Last updated
01/05/2026
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