Jetta Melinda Benner, PT
Individual provider Active NPI Orthopedic Physical Therapist · Cedar Hill, TX
NPI 1073581609 · NPPES record last updated Jan 23, 2014
Key facts
- NPI
- 1073581609
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Physical Therapist 2251X0800X
- License
- 1106805 (TX)
- Practice address
- 638 Uptown Blvd
Suite 1105
Cedar Hill, TX 75104-3507 - Phone
- (469) 272-3129
- Fax
- (469) 272-3145
- NPI assigned
- Mar 9, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 1106805 | TX | Yes |
Addresses
Primary practice location
638 Uptown Blvd
Suite 1105
Cedar Hill, TX 75104-3507
Mailing address
638 Uptown Blvd
Suite 1105
Cedar Hill, TX 75104-3507
Phone (469) 272-3129
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8T1319 | Other | TX | BCBS |
Other providers in Cedar Hill, TX
- Ronda Lawaine Beene
- Kimberly L Belcher
- Bell-Myre'S Residential Community Care Facility, LLC
- Lewis Wayne Bell Jr.
- Jeffrey D Belz
- Yolanda Bennett
- Rochelle Berganciano
- Bespoke Wellness
- Bespoke Wellness
- Bespoke Wellness
All providers in Cedar Hill, TX · Orthopedic Physical Therapist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.