Provider Demographics
NPI:1275036626
Name:DRUMMOND, JESSICA (DCN, CNS, PT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:DCN, CNS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 ALLEN PKWY APT 6205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-1833
Mailing Address - Country:US
Mailing Address - Phone:832-277-7064
Mailing Address - Fax:
Practice Address - Street 1:3231 ALLEN PKWY APT 6205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-1833
Practice Address - Country:US
Practice Address - Phone:832-277-7064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1133825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist