Provider Demographics
NPI:1922275619
Name:JONES, JON KEVIN (PT)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:KEVIN
Last Name:JONES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-5714
Mailing Address - Country:US
Mailing Address - Phone:409-651-1819
Mailing Address - Fax:409-722-8070
Practice Address - Street 1:2415 NASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-5714
Practice Address - Country:US
Practice Address - Phone:409-651-1819
Practice Address - Fax:409-722-8070
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1121390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist