Active NPI
Jessica Tabor
- Physical Therapist
- Aledo, TX
National Provider Identifier
1710711726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1191792
- Practice address
- 1043 Bailey Ranch Rd
Aledo, TX 76008-3149 - Phone
- (817) 875-5289
- NPI assigned
- Aug 30, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1191792 | TX | Primary |
Addresses
Primary practice location
1043 Bailey Ranch Rd
Aledo, TX 76008-3149
Mailing address
164 Lakeview Dr
Aledo, TX 76008-3984
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1191792 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1710711726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 LAKEVIEW DR",
"city": "ALEDO",
"state": "TX",
"postal_code": "760083984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1043 BAILEY RANCH RD",
"city": "ALEDO",
"state": "TX",
"postal_code": "760083149",
"telephone_number": "817-875-5289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABOR",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-30",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1191792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aledo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.