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NPI Code Detail

MEDICARE: MS. DIANE ELIZABETH JONES OTR

MEDICARE: MS. DIANE ELIZABETH JONES OTR
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
1225X00000XOccupational Therapist107496TX

General Provider Information

NPI Number : 1689853624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE ELIZABETH JONES OTR
Provider Business Mailing Address
First Line : 855 E BASSE RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1890
Country : US
Telephone Number : 210-930-1040
Fax Number :
Provider Business Practice Location Address
First Line : 855 E BASSE RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1890
Country : US
Telephone Number : 210-930-1040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2007
Last Update Date : 10/26/2007

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