Jon Barry Davis, PT

Individual provider Active NPI Physical Therapist · Kingsbury, TX

NPI 1053947382 · NPPES record last updated Mar 18, 2020

Key facts

NPI
1053947382
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1101590 (TX)
Practice address
1129 Wade Rd
Kingsbury, TX 78638-1642
Phone
(830) 708-2416
NPI assigned
Mar 18, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1101590TXMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1101590 TX Yes

Addresses

Primary practice location

1129 Wade Rd
Kingsbury, TX 78638-1642

Mailing address

1129 Wade Rd
Kingsbury, TX 78638-1642
Phone (830) 708-2416

Other providers in Kingsbury, TX

All providers in Kingsbury, TX · Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.