Provider Demographics
NPI:1417090747
Name:FLOWERS, JILL F (ATC,LAT)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:F
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 IVYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9254
Mailing Address - Country:US
Mailing Address - Phone:281-489-4848
Mailing Address - Fax:
Practice Address - Street 1:3775 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5905
Practice Address - Country:US
Practice Address - Phone:281-997-3260
Practice Address - Fax:281-412-1369
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT11322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2255A2300XOtherATHLETIC TRAINER