Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evan Boullosa, LPTA

Individual provider Physical Therapy Assistant · NPI 1780412585

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 1385
Fort Sam Houston, TX 78234-7587
Phone: (210) 221-5033
Show map & directions

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 number1780412585
Entity typeIndividual (Type 1)
GenderMale
Credentials LPTA
Sole proprietorNo
NPI enumeratedJuly 23, 2024
Last updated in NPPESJuly 23, 2024
Certification dateJuly 23, 2024
Mailing address227 Dwyer Ave Apt 210, San Antonio, TX 78204-1238

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