Provider Demographics
NPI:1487831806
Name:JONES, SYLVIA D
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 OAKMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2812
Mailing Address - Country:US
Mailing Address - Phone:817-361-1344
Mailing Address - Fax:817-361-1347
Practice Address - Street 1:6231 OAKMONT BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-2812
Practice Address - Country:US
Practice Address - Phone:817-361-1344
Practice Address - Fax:817-361-1347
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC17478335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6131190001Medicare NSC