Provider Demographics
NPI:1306006606
Name:JONES, MARTIN L (PT, CWS)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:PT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531513
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75053-1513
Mailing Address - Country:US
Mailing Address - Phone:972-263-7042
Mailing Address - Fax:972-263-7046
Practice Address - Street 1:504 N CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5428
Practice Address - Country:US
Practice Address - Phone:972-263-7042
Practice Address - Fax:972-263-7046
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX456786Medicare Oscar/Certification