Basic Information
| Provider Information | |||||||||
| NPI: | 1679794283 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCARBROUGH | ||||||||
| FirstName: | JASON | ||||||||
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| Credential: | P.T.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13707 FM 901 | ||||||||
| Address2: | |||||||||
| City: | SADLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9038149054 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2120 HWY 1417 N | ||||||||
| Address2: | |||||||||
| City: | SHERMAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9038924800 | ||||||||
| FaxNumber: | 9038924444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225200000X | 2035202 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.