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NPI Code Detail

MEDICARE: JASON W MANESS PT

MEDICARE: JASON W MANESS PT
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
1225100000XPhysical Therapist1146716TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18T2288OTHERTXBCBS OF TEXAS PROVIDER #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073682753
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON W MANESS PT
Provider Business Mailing Address
First Line : PO BOX 596
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75483-0596
Country : US
Telephone Number : 214-477-0141
Fax Number :
Provider Business Practice Location Address
First Line : 1501 HOLIDAY DR
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-4707
Country : US
Telephone Number : 214-477-0141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/23/2011

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Directions to “ JASON W MANESS PT” Practice Location

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