Healthcare Provider Details

I. General information

NPI: 1851774418
Provider Name (Legal Business Name): JAMIE MARIE THURMAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 12/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 RESEARCH BLVD STE 212
AUSTIN TX
78759-5243
US

IV. Provider business mailing address

12508 JONES MALTSBERGER RD STE 110
SAN ANTONIO TX
78247-4215
US

V. Phone/Fax

Practice location:
  • Phone: 512-794-8863
  • Fax:
Mailing address:
  • Phone: 888-590-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1259548
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: