Healthcare Provider Details

I. General information

NPI: 1851348197
Provider Name (Legal Business Name): VINITA JOBES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 11/27/2023
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 DIRECTORS PKWY
ABILENE TX
79606-5881
US

IV. Provider business mailing address

1302 MEANDER ST
ABILENE TX
79602-3514
US

V. Phone/Fax

Practice location:
  • Phone: 407-489-1270
  • Fax:
Mailing address:
  • Phone: 407-489-1270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number113663
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: