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General NPI Number Information
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NPI Number | 1982157269
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Entity Type | Individual
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Provider Name | ALICE JONES
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 7805 TRIMBLE DR
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City | FORT WORTH
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State | TX
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Zip | 76134-8110
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Country | US
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Telephone | 817-691-1276
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60110
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City | FORT WORTH
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State | TX
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Zip | 76115-8110
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Country | US
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Telephone | 817-691-1276
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 106049
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License Number State | TX
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