Provider Demographics
NPI:1447473178
Name:JAYCOX, TINA MARIE (PTA)
Entity type:Individual
Prefix:MISS
First Name:TINA
Middle Name:MARIE
Last Name:JAYCOX
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:25132 OAKHURST DR
Mailing Address - Street 2:SUITE 195
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1452
Mailing Address - Country:US
Mailing Address - Phone:281-298-5020
Mailing Address - Fax:281-298-5021
Practice Address - Street 1:25132 OAKHURST DR
Practice Address - Street 2:SUITE 195
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1452
Practice Address - Country:US
Practice Address - Phone:281-298-5020
Practice Address - Fax:281-298-5021
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2044493225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant