MEDICARE: JEFFREY RONALD CAIN PT, DPT

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	1174507	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00J21A	OTHER	TX	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740484872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY RONALD CAIN PT, DPT

Provider Business Mailing Address
First Line	:	9303 PINECROFT DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-3181
Country	:	US
Telephone Number	:	281-297-6445
Fax Number	:

Provider Business Practice Location Address
First Line	:	9303 PINECROFT DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-3181
Country	:	US
Telephone Number	:	281-297-6445
Fax Number	:

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

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	02/02/2012

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