MEDICARE: JOHNATHAN BARNHART MOREY VI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1318128	TX

General Provider Information

NPI Number	:	1023678182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNATHAN BARNHART MOREY VI DPT

Provider Business Mailing Address
First Line	:	2006 BOLL ST APT 2071
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-2766
Country	:	US
Telephone Number	:	918-809-4014
Fax Number	:

Provider Business Practice Location Address
First Line	:	8144 WALNUT HILL LN STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4301
Country	:	US
Telephone Number	:	214-346-0677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	06/19/2019

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