Provider Demographics
NPI:1871537787
Name:WARREN, JASON CHRISTOPHER (PT)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:CHRISTOPHER
Last Name:WARREN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 N COLLEGIATE DR
Mailing Address - Street 2:SUITE 550
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-1494
Mailing Address - Country:US
Mailing Address - Phone:903-784-3173
Mailing Address - Fax:903-784-7912
Practice Address - Street 1:201 N COLLEGIATE DR
Practice Address - Street 2:SUITE 550
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-1494
Practice Address - Country:US
Practice Address - Phone:903-784-3173
Practice Address - Fax:903-784-7912
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F3874Medicare PIN