Taylor I.S.D. Jones, PT
Individual provider Active NPI Physical Therapist · Bryan, TX
NPI 1750121422 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1750121422
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1393218 (TX)
- Practice address
- 3700 Cross Park Dr
Bryan, TX 77802-4137 - Phone
- (979) 774-9958
- Fax
- (979) 774-9978
- NPI assigned
- May 29, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240605001739 | TX | Practitioner - Physical Medicine and Rehabilitation | 4385186345 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1393218 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Therapy PC | Physical Therapist | Current |
Accepting new patients |
| Advance Therapy PC | Physical Therapist | Past |
Accepting new patients |
Locations
3700 Cross Park Dr
Bryan, TX 77802
Phone (979) 774-9958
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1393218 | TX | Yes |
Addresses
Primary practice location
3700 Cross Park Dr
Bryan, TX 77802-4137
Mailing address
3700 Cross Park Dr
Bryan, TX 77802-4137
Phone (979) 774-9958
Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.