Provider Demographics
NPI:1376919142
Name:JONES, EVAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-2222
Mailing Address - Country:US
Mailing Address - Phone:806-322-2284
Mailing Address - Fax:806-230-1605
Practice Address - Street 1:616 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-2222
Practice Address - Country:US
Practice Address - Phone:806-322-2284
Practice Address - Fax:806-230-1605
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12004225100000X
TX1263727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist