Provider Demographics
NPI:1811326259
Name:JONES, KATRINA
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 SHADY GROVE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4202
Mailing Address - Country:US
Mailing Address - Phone:214-543-8310
Mailing Address - Fax:
Practice Address - Street 1:2015 E LAMAR BLVD
Practice Address - Street 2:UNIT 200
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7349
Practice Address - Country:US
Practice Address - Phone:817-203-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1187963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist