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NPI 1003366451

NPI 1003366451 : CAROL JONES : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1003366451
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    Entity Type          |    Individual 
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    Provider Name        |    CAROL JONES
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/10/2016
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    Last Update Date     |    10/10/2016
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Provider Practice Location Address
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    Address Line         |    5906 PATRICK HENRY ST 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78233-5219
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    Country              |    US
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    Telephone            |    210-823-5940
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    Fax                  |    210-655-7025
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Provider Business Mailing Address
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    Address Line         |    5906 PATRICK HENRY ST 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78233-5219
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    Country              |    US
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    Telephone            |    210-823-5940
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    Fax                  |    210-655-7025
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    10132
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    License Number State |    TX
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