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NPI Code Detail

MEDICARE: TREY JEFFERS

MEDICARE: TREY JEFFERS
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 Therapist1291225TX

General Provider Information

NPI Number : 1245768050
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREY JEFFERS
Provider Business Mailing Address
First Line : 1900 LONG PRAIRIE RD STE 104
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-4294
Country : US
Telephone Number : 972-724-2400
Fax Number : 972-724-2495
Provider Business Practice Location Address
First Line : 413 W BETHEL RD STE 400
Second Line :
City : COPPELL
State : TX
Zip : 75019-4477
Country : US
Telephone Number : 972-304-9100
Fax Number : 972-304-9048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2017
Last Update Date : 05/24/2017

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Directions to “ TREY JEFFERS ” Practice Location

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