Provider Demographics
NPI:1427418169
Name:HUTCHISON, JENNIFER KAY (PTA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:KAY
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 COUNTY ROAD 2600
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-2346
Mailing Address - Country:US
Mailing Address - Phone:713-376-5411
Mailing Address - Fax:
Practice Address - Street 1:1620 HIGHWAY 59 LOOP N
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9988
Practice Address - Country:US
Practice Address - Phone:936-327-5415
Practice Address - Fax:936-327-7849
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2091568225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant