Basic Information
| Provider Information | |||||||||
| NPI: | 1043553837 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | THOMAS | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5306 EL MEDANO ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782335416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105992101 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3453 IH 35 N | ||||||||
| Address2: | SUITE 207B | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782192333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105874606 | ||||||||
| FaxNumber: | 2102982658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2013 | ||||||||
| LastUpdateDate: | 04/01/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 204219 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.