Provider Demographics
NPI:1144527474
Name:JONES, BLAIR (PTA)
Entity type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26795 US HIGHWAY 380 E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-7853
Mailing Address - Country:US
Mailing Address - Phone:972-347-6000
Mailing Address - Fax:972-347-6001
Practice Address - Street 1:26795 US HIGHWAY 380 E
Practice Address - Street 2:SUITE 200
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-7853
Practice Address - Country:US
Practice Address - Phone:972-347-6000
Practice Address - Fax:972-347-6001
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2068568225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant