Provider Demographics
NPI:1679028054
Name:SPARLING, JAYMIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAYMIE
Middle Name:
Last Name:SPARLING
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 1:1313 N BELT LINE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1783
Mailing Address - Country:US
Mailing Address - Phone:972-289-0691
Mailing Address - Fax:972-289-0607
Practice Address - Street 1:1313 N BELT LINE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1783
Practice Address - Country:US
Practice Address - Phone:972-289-0691
Practice Address - Fax:972-289-0607
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1279197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist