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NPI Code Detail

MEDICARE: NEDA JOBY

MEDICARE: NEDA JOBY
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
1363A00000XPhysician AssistantPA15894TX

General Provider Information

NPI Number : 1639780380
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEDA JOBY
Provider Business Mailing Address
First Line : 1521 13TH ST
Second Line :
City : ARGYLE
State : TX
Zip : 76226-1983
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1301 N BEACH ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76111-6613
Country : US
Telephone Number : 817-831-3388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2020
Last Update Date : 05/24/2023

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Directions to “ NEDA JOBY ” Practice Location

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