Provider Demographics
NPI:1215181946
Name:KOZEL, JASON ANDREW (PT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ANDREW
Last Name:KOZEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 STUDEMONT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3803
Mailing Address - Country:US
Mailing Address - Phone:346-701-3820
Mailing Address - Fax:346-237-8725
Practice Address - Street 1:1431 STUDEMONT ST STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3803
Practice Address - Country:US
Practice Address - Phone:346-701-3820
Practice Address - Fax:346-237-8725
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist