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NPI Code Detail

MEDICARE: JENNI-MAARI ANTUNEZ PT

MEDICARE:   JENNI-MAARI  ANTUNEZ  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 Therapist

General Provider Information

NPI Number : 1205599529
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNI-MAARI ANTUNEZ PT
Provider Business Mailing Address
First Line : 19643 RUGGLES CT W
Second Line :
City : FLINT
State : TX
Zip : 75762-8777
Country : US
Telephone Number : 903-316-3220
Fax Number :
Provider Business Practice Location Address
First Line : 5407 NEW COPELAND RD STE 100
Second Line :
City : TYLER
State : TX
Zip : 75703-3997
Country : US
Telephone Number : 903-630-7204
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2021
Last Update Date : 10/14/2021

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Directions to “ JENNI-MAARI ANTUNEZ PT” Practice Location

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