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General NPI Number Information
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NPI Number | 1376211557
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Entity Type | Individual
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Provider Name | THERESA JONES NP
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Gender | Female
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 1517 E RUSK ST FL 3
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City | JACKSONVILLE
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State | TX
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Zip | 75766-5505
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Country | US
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Telephone | 903-339-3392
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Fax |
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Provider Business Mailing Address
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Address Line | 955 REDBUD LN
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City | BULLARD
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State | TX
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Zip | 75757-5093
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Country | US
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Telephone | 214-683-5075
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1032808
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License Number State | TX
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