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General NPI Number Information
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NPI Number | 1326330796
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Entity Type | Individual
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Provider Name | JAY WALTER PIERSON SR. ATC, LAT, CSCS, PES
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Gender | Male
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 18200 KATY FWY FL 5 ORTHOPEDICS & SPORTS MEDICINE DEPT
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City | HOUSTON
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State | TX
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Zip | 77094-1285
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Country | US
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Telephone | 832-227-2445
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Fax | 832-825-9335
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Provider Business Mailing Address
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Address Line | 18200 KATY FWY FL 5 ORTHOPEDICS & SPORTS MEDICINE DEPT
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City | HOUSTON
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State | TX
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Zip | 77094-1285
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Country | US
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Telephone | 832-227-2445
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Fax | 832-825-9335
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT2573
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License Number State | TX
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