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General NPI Number Information
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NPI Number | 1124051727
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Entity Type | Individual
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Provider Name | JED S. MCNALLY PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 203 CEDAR DR
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City | PORTLAND
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State | TX
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Zip | 78374-2900
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Country | US
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Telephone | 361-643-3993
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Fax | 361-687-2465
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Provider Business Mailing Address
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Address Line | 2011 HIGHWAY 35 N
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City | ROCKPORT
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State | TX
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Zip | 78382-3302
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Country | US
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Telephone | 361-729-2225
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Fax | 361-729-2483
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1151595
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License Number State | TX
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