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General NPI Number Information
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NPI Number | 1164213310
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Entity Type | Individual
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Provider Name | JAKE SCOTT WILLIAMS PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 3445 GOLDEN TRIANGLE BLVD
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City | FORT WORTH
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State | TX
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Zip | 76177-7166
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Country | US
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Telephone | 817-812-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 733 N HAMPTON ST APT 3212
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City | FORT WORTH
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State | TX
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Zip | 76102-1672
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Country | US
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Telephone | 214-450-1194
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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