Provider Demographics
NPI:1578989398
Name:DULAY, JAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:DULAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21978 WHITETAIL XING
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-4740
Mailing Address - Country:US
Mailing Address - Phone:832-385-8547
Mailing Address - Fax:
Practice Address - Street 1:21978 WHITETAIL XING
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-4740
Practice Address - Country:US
Practice Address - Phone:832-385-8547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12186282251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics