Provider Demographics
NPI:1477659357
Name:TOUT, JEFFREY ARRON (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ARRON
Last Name:TOUT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PALUXY RD
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5663
Mailing Address - Country:US
Mailing Address - Phone:817-573-8204
Mailing Address - Fax:817-573-8472
Practice Address - Street 1:1301 PALUXY RD
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5663
Practice Address - Country:US
Practice Address - Phone:817-573-8204
Practice Address - Fax:817-573-8472
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7047011OtherAETNA
TX83294TOtherBLUE CROSS BLUE SHIELD
TX83294TOtherBLUE CROSS BLUE SHIELD