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NPI Code Detail

MEDICARE: JEREMY JOSEPHS PT, DPT

MEDICARE: JEREMY JOSEPHS PT, 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 Therapist1212139TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21212139OTHERTXMANAGED CARE

General Provider Information

NPI Number : 1184105843
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY JOSEPHS PT, DPT
Provider Business Mailing Address
First Line : 2101 LONE COTTONWOOD CT
Second Line :
City : BURLESON
State : TX
Zip : 76028-7680
Country : US
Telephone Number : 570-417-3816
Fax Number :
Provider Business Practice Location Address
First Line : 7625 GLENVIEW DR
Second Line :
City : RICHLAND HILLS
State : TX
Zip : 76180-8331
Country : US
Telephone Number : 570-417-3816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2018
Last Update Date : 06/26/2026

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