Provider Demographics
NPI:1205246758
Name:CURLEE, JACK MILTON JR (MA)
Entity type:Individual
Prefix:MR
First Name:JACK
Middle Name:MILTON
Last Name:CURLEE
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3629 WESTERN CENTER BLVD.
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137
Mailing Address - Country:US
Mailing Address - Phone:817-232-9400
Mailing Address - Fax:817-232-9403
Practice Address - Street 1:3629 WESTERN CENTER BLVD.
Practice Address - Street 2:SUITE 211
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137
Practice Address - Country:US
Practice Address - Phone:817-232-9400
Practice Address - Fax:817-232-9403
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional