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NPI Code Detail

MEDICARE: ALICE JONES

MEDICARE: ALICE JONES
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
1172V00000XCommunity Health Worker106049TX

General Provider Information

NPI Number : 1982157269
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE JONES
Provider Business Mailing Address
First Line : PO BOX 60110
Second Line :
City : FORT WORTH
State : TX
Zip : 76115-8110
Country : US
Telephone Number : 817-691-1276
Fax Number :
Provider Business Practice Location Address
First Line : 7805 TRIMBLE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76134-8110
Country : US
Telephone Number : 817-691-1276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2016
Last Update Date : 08/03/2016

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Directions to “ ALICE JONES ” Practice Location

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