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NPI Code Detail

MEDICARE: JENNIFER JUNEAU PT

MEDICARE: JENNIFER JUNEAU PT
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 Therapist1153710TX

General Provider Information

NPI Number : 1952790958
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER JUNEAU PT
Provider Business Mailing Address
First Line : 10106 BROOKSHORE LN
Second Line :
City : PEARLAND
State : TX
Zip : 77584-3146
Country : US
Telephone Number : 504-231-2959
Fax Number :
Provider Business Practice Location Address
First Line : 4900 E SAM HOUSTON PKWY S
Second Line :
City : PASADENA
State : TX
Zip : 77505-1400
Country : US
Telephone Number : 281-998-0399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2015
Last Update Date : 01/13/2015

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