Basic Information
| Provider Information | |||||||||
| NPI: | 1205181260 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | MCKENZIE | ||||||||
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| Credential: | MSOTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 918 HEIGHTS BLVD | ||||||||
| Address2: | #11 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770086975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525020279 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7407 NORTH FWY | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770761314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322006000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2012 | ||||||||
| LastUpdateDate: | 07/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 114789 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.