Provider Demographics
NPI:1003016510
Name:TROJACEK, JASON WAYNE (MPT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:WAYNE
Last Name:TROJACEK
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 N. ELLIS
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642
Mailing Address - Country:US
Mailing Address - Phone:254-729-0323
Mailing Address - Fax:254-729-0328
Practice Address - Street 1:1023 N. ELLIS
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642
Practice Address - Country:US
Practice Address - Phone:254-729-0323
Practice Address - Fax:254-729-0328
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1144632225100000X, 2251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic