Provider Demographics
NPI:1407736960
Name:PELLETT, JEFFREY BRADFORD (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BRADFORD
Last Name:PELLETT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10513 NORTHBEND RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-4532
Mailing Address - Country:US
Mailing Address - Phone:314-609-0627
Mailing Address - Fax:
Practice Address - Street 1:4242 BRYANT IRVIN RD
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76109-4222
Practice Address - Country:US
Practice Address - Phone:817-754-5992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1291791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist