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NPI Code Detail

MEDICARE: ANDREA JARVIS DPT

MEDICARE: ANDREA JARVIS DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1295895TX

General Provider Information

NPI Number : 1033634738
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JARVIS DPT
Provider Business Mailing Address
First Line : 1836 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6422
Country : US
Telephone Number : 817-341-7611
Fax Number : 817-599-7655
Provider Business Practice Location Address
First Line : 1836 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6422
Country : US
Telephone Number : 817-341-7611
Fax Number : 817-599-7655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2017
Last Update Date : 07/21/2022

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