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General NPI Number Information
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NPI Number | 1831700434
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Entity Type | Individual
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Provider Name | JACQUELINE LO ABELLA PT
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Gender | Female
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 801 ROAD TO SIX FLAGS W STE 147
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City | ARLINGTON
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State | TX
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Zip | 76012-2600
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Country | US
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Telephone | 817-462-8111
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Fax | 817-462-8110
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Provider Business Mailing Address
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Address Line | 1219 AUTUMN MIST WAY
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City | ARLINGTON
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State | TX
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Zip | 76005-4531
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Country | US
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Telephone | 817-896-2294
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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 | 1066983
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License Number State | TX
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