Provider Demographics
NPI:1073700274
Name:REESE, JAMIE LOGSDON (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LOGSDON
Last Name:REESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12508 JONES MALTSBERGER RD
Mailing Address - Street 2:STE. 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4214
Mailing Address - Country:US
Mailing Address - Phone:888-590-4002
Mailing Address - Fax:210-590-4585
Practice Address - Street 1:711 W 38TH ST
Practice Address - Street 2:SUITE C-11
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1121
Practice Address - Country:US
Practice Address - Phone:512-302-3922
Practice Address - Fax:512-795-0688
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist