1235827114 NPI number — KATELYNN D JONES DC

Table of content: KATELYNN D JONES DC (NPI 1235827114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235827114 NPI number — KATELYNN D JONES DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
KATELYNN
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235827114
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 SE MELODY LN STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEES SUMMIT
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64063-4804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-219-1977
Provider Business Mailing Address Fax Number:
816-434-0898

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10905 MEMORIAL HERMANN DR STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-3490
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-324-7220
Provider Business Practice Location Address Fax Number:
713-324-7221
Provider Enumeration Date:
04/27/2023

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: 111N00000X , with the licence number:  15460 , 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)