Thomas Edell Jenkins, PTA
Individual provider Active NPI Physical Therapy Assistant · Daingerfield, TX
NPI 1407330798 · NPPES record last updated Sep 21, 2018
Key facts
- NPI
- 1407330798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2095450 (TX)
- Practice address
- 1042 County Road 1124
Daingerfield, TX 75638-7348 - Phone
- (903) 452-4272
- NPI assigned
- Sep 21, 2018
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2095450 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2095450 | TX | Yes |
Addresses
Primary practice location
1042 County Road 1124
Daingerfield, TX 75638-7348
Mailing address
1042 County Road 1124
Daingerfield, TX 75638-7348
Phone (903) 452-4272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2095450 | Medicaid | TX |
Other providers in Daingerfield, TX
- Fannin County Hospital Authority
- Morgan Frost
- Alvin Eugene Hinson
- J Jireh LLC
- J. Nissi Healthcare, Inc.
- Jerel Lynn Kerby
- Lynn S. Lain
- Trey Matthew Latiolais
- James David Lewis
- Danny Lilley
All providers in Daingerfield, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2018. 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.