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General NPI Number Information
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NPI Number | 1013694363
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Entity Type | Individual
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Provider Name | JAY-CHEREE BURNS PTA
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Gender | Female
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 13903 MOWBRAY CT
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City | RICHMOND
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State | TX
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Zip | 77407-1543
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Country | US
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Telephone | 201-931-5635
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 SWEET DUMPLING DR
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City | RICHMOND
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State | TX
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Zip | 77406-1766
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Country | US
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Telephone | 301-437-9634
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2144984
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License Number State | TX
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