Provider Demographics
NPI:1639460348
Name:PIERRE LOUIS, JENNIFER GAYE (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GAYE
Last Name:PIERRE LOUIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 HEARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2232
Mailing Address - Country:US
Mailing Address - Phone:512-828-6569
Mailing Address - Fax:
Practice Address - Street 1:1701 W BEN WHITE BLVD
Practice Address - Street 2:SUITE 100B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7667
Practice Address - Country:US
Practice Address - Phone:512-440-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106870261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy