MEDICARE: MR. JASON ANDREW KOZEL 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
1	225100000X	Physical Therapist	1141000	TX

General Provider Information

NPI Number	:	1215181946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON ANDREW KOZEL PT

Provider Business Mailing Address
First Line	:	1431 STUDEMONT ST STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-3803
Country	:	US
Telephone Number	:	346-701-3820
Fax Number	:	346-237-8725

Provider Business Practice Location Address
First Line	:	1431 STUDEMONT ST STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-3803
Country	:	US
Telephone Number	:	346-701-3820
Fax Number	:	346-237-8725

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

Provider Enumeration Date	:	11/07/2008
Last Update Date	:	07/31/2020

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