Healthcare Provider Details

I. General information

NPI: 1033013545
Provider Name (Legal Business Name): LORI JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 ROYAL DR
HEWITT TX
76643-2959
US

IV. Provider business mailing address

1715 PORT AVE
INGLESIDE TX
78362-4830
US

V. Phone/Fax

Practice location:
  • Phone: 254-777-5042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2060620
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: