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NPI Code Detail

MEDICARE: JEANA FLETCHER

MEDICARE: JEANA FLETCHER
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
1225200000XPhysical Therapy Assistant2090029TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117922377OTHERTXDRIVERS LICENSE

General Provider Information

NPI Number : 1831671619
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANA FLETCHER
Provider Business Mailing Address
First Line : 2228 WHITNEY RD
Second Line :
City : DENISON
State : TX
Zip : 75021-4370
Country : US
Telephone Number : 737-881-9094
Fax Number :
Provider Business Practice Location Address
First Line : 601 E US HIGHWAY 69
Second Line :
City : DENISON
State : TX
Zip : 75021-6510
Country : US
Telephone Number : 903-465-2438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2018
Last Update Date : 08/29/2018

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Directions to “ JEANA FLETCHER ” Practice Location

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