=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912252396
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOCELYN MAY-FUNG FU PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2012
-----------------------------------------------------
Last Update Date | 07/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4440 HIGH MESA DR
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-3255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-315-4994
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4440 HIGH MESA DR
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-3255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-315-4994
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1219727
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------