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NPI Code Detail

MEDICARE: JORMAN VASQUEZ

MEDICARE: JORMAN VASQUEZ
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 Therapist1407549TX

General Provider Information

NPI Number : 1730042607
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORMAN VASQUEZ
Provider Business Mailing Address
First Line : 2001 BUTTERFIELD RD STE 1600
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-1211
Country : US
Telephone Number : 866-307-8206
Fax Number :
Provider Business Practice Location Address
First Line : 3141 E BROAD ST STE 111
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-6425
Country : US
Telephone Number : 817-435-5248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2025
Last Update Date : 12/19/2025

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Directions to “ JORMAN VASQUEZ ” Practice Location

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