Provider Demographics
NPI:1942963236
Name:AUTEN, JENA-CLAIRE (PT)
Entity Type:Individual
Prefix:
First Name:JENA-CLAIRE
Middle Name:
Last Name:AUTEN
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 1:601 EASLEY ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-1407
Mailing Address - Country:US
Mailing Address - Phone:432-266-7623
Mailing Address - Fax:
Practice Address - Street 1:1212 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-7012
Practice Address - Country:US
Practice Address - Phone:713-203-0787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic