Evan Boullosa, LPTA
Evan Boullosa, LPTA is a Physical Therapy Assistant in Fort Sam Houston, Texas. Licensed in Texas. Registered with an NPI since 2024.
- Licensed in
- TX
- In the registry since
- 2024
Practice location Address checks out
3265 Koehler Rd Bldg 1385Fort Sam Houston, TX 78234-7587
Phone: (210) 221-5033
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapy Assistant (primary) | Taxonomy 225200000X · Licence 2159129 (TX) |
|---|
Record details
| NPI number | 1780412585 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LPTA |
| Sole proprietor | No |
| NPI enumerated | July 23, 2024 |
| Last updated in NPPES | July 23, 2024 |
| Certification date | July 23, 2024 |
| Mailing address | 227 Dwyer Ave Apt 210, San Antonio, TX 78204-1238 |
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