Provider Demographics
NPI:1700973518
Name:HOLMES, JON BRENT (PT, CP)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:BRENT
Last Name:HOLMES
Suffix:
Gender:M
Credentials:PT, CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8998 KIRBY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2830
Mailing Address - Country:US
Mailing Address - Phone:713-432-9949
Mailing Address - Fax:713-799-1260
Practice Address - Street 1:8998 KIRBY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2830
Practice Address - Country:US
Practice Address - Phone:713-432-9949
Practice Address - Fax:713-799-1260
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213224P00000X
TX10248002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic