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General NPI Number Information
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NPI Number | 1497033633
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Entity Type | Individual
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Provider Name | JONSON YOUSEFZADEH PT, DPT, COMPT, CSCS
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Gender | Male
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 10/24/2015
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Provider Practice Location Address
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Address Line | 7616 LBJ FWY STE 640
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City | DALLAS
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State | TX
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Zip | 75251-1184
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Country | US
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Telephone | 214-960-4038
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 S MO PAC EXPY APT 1328
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City | AUSTIN
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State | TX
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Zip | 78749-1183
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Country | US
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Telephone |
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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 | PT 26669
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1250831
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License Number State | TX
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