Provider Demographics
NPI:1003600941
Name:PACIOUS, JEREMY M (DPT)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:M
Last Name:PACIOUS
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 1:27911 WEDGEOAK CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3371
Mailing Address - Country:US
Mailing Address - Phone:518-376-6455
Mailing Address - Fax:
Practice Address - Street 1:2260 LOGAN BLVD N UNIT 302
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-1491
Practice Address - Country:US
Practice Address - Phone:239-342-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic