Provider Demographics
NPI:1447739487
Name:NELMS, JARRETT K
Entity Type:Individual
Prefix:
First Name:JARRETT
Middle Name:K
Last Name:NELMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-5212
Mailing Address - Country:US
Mailing Address - Phone:903-785-4222
Mailing Address - Fax:903-784-6020
Practice Address - Street 1:1025 DESHONG DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9330
Practice Address - Country:US
Practice Address - Phone:903-785-4222
Practice Address - Fax:903-784-6020
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2101520225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant