Provider Demographics
NPI:1811270556
Name:JONES, KEITH AARON (DPT)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:AARON
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12702 TOEPPERWEIN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3278
Mailing Address - Country:US
Mailing Address - Phone:210-653-4420
Mailing Address - Fax:210-653-3183
Practice Address - Street 1:12702 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3278
Practice Address - Country:US
Practice Address - Phone:210-653-4420
Practice Address - Fax:210-653-3183
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1211055225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist