Provider Demographics
NPI:1568775625
Name:JEFFERY HEALTHCARE LLC
Entity Type:Organization
Organization Name:JEFFERY HEALTHCARE LLC
Other - Org Name:HOPE HOME REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JEFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:512-796-3954
Mailing Address - Street 1:4341 ROLLING WATER DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5577
Mailing Address - Country:US
Mailing Address - Phone:512-720-8151
Mailing Address - Fax:512-605-3746
Practice Address - Street 1:4341 ROLLING WATER DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-5577
Practice Address - Country:US
Practice Address - Phone:512-796-3954
Practice Address - Fax:512-989-9667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11371312251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1137131OtherSTATE LICENSE