Provider Demographics
NPI:1376320911
Name:JONES, TRIVETT (AT)
Entity Type:Individual
Prefix:
First Name:TRIVETT
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8417 VICTORY ST
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-9147
Mailing Address - Country:US
Mailing Address - Phone:214-952-1626
Mailing Address - Fax:
Practice Address - Street 1:8417 VICTORY ST
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-9147
Practice Address - Country:US
Practice Address - Phone:214-952-1626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT92212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer