Phase 4 Physiotherapy – Interventional Pain Medicine Physician, NPI 1619244720
Interventional Pain Medicine Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Phase 4 Physiotherapy
19141 STONE OAK PKWY STE 104
SAN ANTONIO, TX 782583367
Phone: (210) 268-0129
Fax: (210) 568-4064
Type: Mailing
PO BOX 642016
DALLAS, TX 752642016
Phone: (210) 756-5989
Fax: (210) 568-4064
Type: Mailing
2600 SW Military Dr Ste 230
San Antonio, TX 782241012
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
4544 S Lamar Blvdd, Building #700
Suite 200
Austin, TX 787451575
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
4325 N Josey Ln, Plaza III
Suite 206
Carrollton, TX 750104637
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
1011 S State Highway 16 Ste 5
Fredericksburg, TX 786244472
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
14800 San Pedro Ave Ste 115
San Antonio, TX 782323734
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
1110 Cottonwood Ln Ste 110
Irving, TX 750386121
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
7215 Wyoming Springs Dr Ste 200
Round Rock, TX 786814314
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
110 STONE OAK LOOP STE 103
SAN ANTONIO, TX 782583511
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
1521 S Staples St Ste 203
Corpus Christi, TX 784043157
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
18707 Hardy Oak Blvd Ste 230
San Antonio, TX 782584890
Phone: (447) 897-2468
Fax: (888) 880-9323
Type: Location
3338 Oakwell Ct Ste 104
San Antonio, TX 782183087
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
8627 Cinnamon Creek Dr Bldg 100
San Antonio, TX 782401480
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
717 Generations Dr Ste B
New Braunfels, TX 781300009
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
18707 Hardy Oak Blvd Ste 500
San Antonio, TX 782584841
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
5802 Saratoga Blvd Ste 330
Corpus Christi, TX 784144252
Phone: (844) 789-7246
Fax: (888) 880-9323
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-01-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-11-30 (923 days ago).
Enrollment records
2
Earliest due date
2023-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20120326000089 | O | Clinic/Group Practice | TX | 2025-10-31 |
| O20200125000434 | O | Physician - Interventional Pain Management | TX | 2023-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 78258)
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