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General NPI Number Information
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NPI Number | 1871732776
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Entity Type | Individual
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Provider Name | JENNIFER ANN SURMA DPT
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Gender | Female
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 100 E KLEBERG AVE STE 336
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City | KINGSVILLE
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State | TX
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Zip | 78363-4581
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Country | US
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Telephone | 512-821-1101
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Fax | 512-821-1071
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Provider Business Mailing Address
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Address Line | 12417 N. MOPAC EXPWY. STE 575
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City | AUSTIN
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State | TX
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Zip | 78758-2410
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Country | US
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Telephone | 512-821-1101
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Fax | 512-821-1071
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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 | 1170258
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License Number State | TX
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