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General NPI Number Information
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NPI Number | 1790493997
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Entity Type | Organization
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Legal Business Name | JESSICA NOVAK, PLLC
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 4411 BELMONT AVE
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City | DALLAS
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State | TX
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Zip | 75204-3004
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Country | US
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Telephone | 806-236-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 8450 SWEETWATER DR
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City | DALLAS
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State | TX
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Zip | 75228-5844
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Country | US
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Telephone | 806-236-4726
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. JESSICA NOVAK
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Credential | PT, DPT
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Telephone | 806-236-4726
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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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