1952358731 NPI number — PATTI RUTH MEYERS-JONES MS, PT, CLT

Table of content: PATTI RUTH MEYERS-JONES MS, PT, CLT (NPI 1952358731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952358731 NPI number — PATTI RUTH MEYERS-JONES MS, PT, CLT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEYERS-JONES
Provider First Name:
PATTI
Provider Middle Name:
RUTH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, PT, CLT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEYERS-JONES
Provider Other First Name:
PATTI
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, PT, CLT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952358731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 226656
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75222-6656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-943-9431
Provider Business Mailing Address Fax Number:
214-943-9407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
430 S TRADE DAYS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75103-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-567-6106
Provider Business Practice Location Address Fax Number:
903-567-5115
Provider Enumeration Date:
05/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1223337 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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