Provider Demographics
NPI:1548498876
Name:DENTON, JEFF DARREN (PT)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:DARREN
Last Name:DENTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK DR
Mailing Address - Street 2:#2051
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2110
Mailing Address - Country:US
Mailing Address - Phone:806-355-4900
Mailing Address - Fax:806-468-4973
Practice Address - Street 1:3501 S SONCY RD STE 137
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6406
Practice Address - Country:US
Practice Address - Phone:806-331-6084
Practice Address - Fax:806-331-6085
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1092526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist