Provider Demographics
NPI:1083083968
Name:JONES, BARRY KELTON (MED, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:KELTON
Last Name:JONES
Suffix:
Gender:M
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 JOHN CT
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1143
Mailing Address - Country:US
Mailing Address - Phone:214-496-7066
Mailing Address - Fax:214-496-7056
Practice Address - Street 1:185 W PARKWAY BLVD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2229
Practice Address - Country:US
Practice Address - Phone:214-496-7066
Practice Address - Fax:214-496-7056
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT26732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer