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General NPI Number Information
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NPI Number | 1144418112
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Entity Type | Individual
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Provider Name | JASON L LAND PT
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Gender | Male
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 940 HESTER'S CROSSING
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City | ROUND ROCK
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State | TX
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Zip | 78681-8018
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Country | US
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Telephone | 512-244-9024
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Fax | 512-460-7342
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Provider Business Mailing Address
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Address Line | 4515 SETON CENTER PARKWAY SUITE 215-CREDENTIALING
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City | AUSTIN
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State | TX
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Zip | 78759-5785
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Country | US
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Telephone | 512-231-5506
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Fax | 512-406-6216
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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 | 1157577
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License Number State | TX
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