Jacob Jezak

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2139333 Issued in TX

Practice address

230 S Clark Rd
Cedar Hill, TX 75104-2750

Phone

(972) 291-7877

NPI assigned

Aug 8, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1447739701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 LE MANS CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760162937",
            "telephone_number": "817-253-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S CLARK RD",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042750",
            "telephone_number": "972-291-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEZAK",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2139333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanbriel Dashay Jackson, LPC
• Shanta D Jackson
• Tonjolique Dabria James, DDS
• Ieshea Daniella Jarmon, PSY.D.
• Dennis Erwin Javier, P.T.
• Jeswina John
• Carletta Kay Johnson, L.P.C.
• Charlotte Ladale Johnson, LVN
• Katandria Johnson, DRPH
• Markeita Danielle Johnson, NP

• Physical Therapy Assistant in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.