MEDICARE: MR. ROBERT D JONES P.T.

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
1	225100000X	Physical Therapist	1067783	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83401T	OTHER	TX	BLUECROSS AND BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5286318	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1255440038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT D JONES P.T.

Provider Business Mailing Address
First Line	:	4849 N MESA ST STE 201
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5919
Country	:	US
Telephone Number	:	915-351-6600
Fax Number	:	915-351-6601

Provider Business Practice Location Address
First Line	:	7500 N MESA ST
Second Line	:	SUITE 215
City	:	EL PASO
State	:	TX
Zip	:	79912-3501
Country	:	US
Telephone Number	:	915-585-1888
Fax Number	:	915-585-1889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/30/2021

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